In today’s rapidly advancing healthcare industry, managing grievances has become more complex than ever. With rising regulatory scrutiny, evolving patient expectations, and a growing demand for efficiency, health plans and pharmacy benefit managers (PBMs) need...
Agadia Expands Market Reach with a ePA Portal for Specialty Drugs Empowering Specialty Pharmacies, Hub Service Companies, and Drug Manufacturers to Expedite Patient Access Agadia is proud to announce the expansion of its electronic prior authorization (ePA)...
Last year, the Centers for Medicare & Medicaid Services (CMS) finalized the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), a significant step toward improving healthcare efficiency, enhancing patient access to care, and reducing...
One of the most common and often misunderstood components of insurance plans is prior authorization (PA). While it might seem like an extra hurdle, PA plays a significant role in healthcare cost management and patient safety. Key Takeaways: Prior authorization ensures...
The Centers for Medicare & Medicaid Services (CMS) recently released updated guidelines for the Medication Therapy Management (MTM) program, effective January 1, 2025. These changes significantly impact how health plans and PBMs can participate and deliver...
