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Insurers Promise to Speed Up Delays in Health Care Approvals

Physician's Weekly

Insurers must provide clearer explanations when care is denied and explain how patients can appeal. By 2027, at least 80% of electronic prior authorization requests will be answered in real time, and the process will be easier to do online.

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When Worlds Collide: The Theory of Real-World Evidence Meets Reality

FDA Law

RWD can be collected from a wide range of sources, such as electronic health records, registries, administrative claims, pharmacy data, and feedback from wearables and mobile technology. Rather than looking at how RWD/RWE provide meaningful information on safety and effectiveness, reviewers often focus on perceived gaps.

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RWE There Yet? FDA’s New Pilot Program Seeks to Help Usher in a New Era for Real World Evidence

FDA Law

These data are routinely collected from a variety of sources, such as electronic health records, providing information on health and healthcare in actual patients, rather than in the controlled environment of a clinical trial. There will be two submission deadlines per year on March 31 and September 30, through March 31, 2027.

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5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization

Physician's Weekly

Health insurers will still be allowed to deny doctor-recommended care, which is arguably the biggest criticism that patients and providers level against insurance companies. Prior authorization isn’t going anywhere. Those rules apply only to certain categories of insurance, including Medicare Advantage and Medicaid.