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Accelerating the Prior Authorization Process: How a 2-Day Rule Can Optimize Efficient Care
On this episode of Managed Care Cast, we speak with April Todd, senior vice president, CORE and Explorations for CAQH. We discuss CAQH CORE’s recent approval of a 2-day rule for health plans in requesting additional supporting information from providers and making final determinations on prior authorization requests.
Prior authorizations play a key role in checking on the safety and appropriateness of medical treatments among patients, but when they take too long, efficiency of care suffers.
On this episode of Managed Care Cast, we speak with April Todd, senior vice president, CORE and Explorations for CAQH, on CAQH CORE’s recent approval of a 2-day rule for health plans in requesting additional supporting information from providers and making final determinations on prior authorization requests. CAQH CORE is a multi-stakeholder collaboration aimed at creating healthcare operating rules for electronic administrative transactions and establishing a common foundation for the operational components of value-based payment.
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Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
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ERISA Industry Committee Sues Minnesota Over PBM Law
January 3rd 2025The Employee Retirement Income Security Act (ERISA) Industry Committee filed a legal challenge against the Minnesota Department of Commerce, arguing that Minnesota’s Pharmacy Benefit Manager (PBM) Licensure and Regulation Act illegally interfered with employer-sponsored health plans by restricting plan design options and increasing costs.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Contributor: The Diabetes Vendor Resource Guide—A Useful Directory for Employers
November 13th 2024Employees living with diabetes often face unique challenges, such as managing blood sugar levels, balancing medication, and preventing complications, all while maintaining their professional responsibilities. This condition can lead to increased absenteeism, reduced productivity, and rising health care costs.
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