# prior authorization — RSS Amplifier Recent posts from the 4 feeds in the RSS Amplifier directory that cover prior authorization. Page: Feed: --- ## [Prior Authorization](https://thehealthcareblog.com/blog/2026/08/20/prior-authorization/) _2026-08-20 · matthew holt · The Health Care Blog_ By EMANUEL SARKEES Most people have never heard of prior authorization until it personally stops them from getting care they actually need. The way it usually goes is pretty straightforward: a doctor Continue reading... ## [Universal Coverage Might Be Nice, but an AI Tax Is Necessary](https://thehealthcareblog.com/blog/2026/08/18/universal-coverage-might-be-nice-but-an-ai-tax-is-necessary/) _2026-08-18 · matthew holt · The Health Care Blog_ By KIM BELLARD I was amused – oh, I should be polite and say “interested” — to see a new study, led by researchers from Yale School of Public Medicine, about the Continue reading... ## [Pre-Surgical Complications (Part 6) — The Decision](https://thehealthcareblog.com/blog/2026/08/17/pre-surgical-complications-part-6-the-decision/) _2026-08-17 · matthew holt · The Health Care Blog_ By MATTHEW HOLT Strap in for the tale of why your hero is spending most of his life down YouTube rabbit holes of cardiology videos while blundering his way around many many Continue reading... ## [Pre-Surgical Complications (Part 5)](https://thehealthcareblog.com/blog/2026/08/14/pre-surgical-complications-part-5/) _2026-08-14 · matthew holt · The Health Care Blog_ By MATTHEW HOLT Strap in for the tale of why your hero is spending most of his life down YouTube rabbit holes of cardiology videos while blundering his way around many many Continue reading... ## [Pre-Surgical Complications (Part 4)](https://thehealthcareblog.com/blog/2026/08/13/pre-surgical-complications-part-4/) _2026-08-13 · matthew holt · The Health Care Blog_ By MATTHEW HOLT Strap in for the tale of why your hero is spending most of his life down YouTube rabbit holes of cardiology videos while blundering his way around many many Continue reading... ## [Pre-Surgical Complications (Part 3)](https://thehealthcareblog.com/blog/2026/08/12/pre-surgical-complications-part-3/) _2026-08-12 · matthew holt · The Health Care Blog_ By MATTHEW HOLT Strap in for the tale of why your hero is spending most of his life down YouTube rabbit holes of cardiology videos while blundering his way around many many Continue reading... ## [Pre-Surgical Complications (Part 2)](https://thehealthcareblog.com/blog/2026/08/11/pre-surgical-complications-part-2/) _2026-08-11 · matthew holt · The Health Care Blog_ By MATTHEW HOLT Strap in for the tale of why your hero is spending most of his life down YouTube rabbit holes of cardiology videos while blundering his way around many many Continue reading... ## [Pre-Surgical Complications (Part 1)](https://thehealthcareblog.com/blog/2026/08/10/pre-surgical-complications-part-1/) _2026-08-10 · matthew holt · The Health Care Blog_ By MATTHEW HOLT Strap in for the tale of why your hero is spending most of his life down YouTube rabbit holes of cardiology videos while blundering his way around many many Continue reading... ## [Is There Hope for Parkinson’s Disease Patients?](https://thehealthcareblog.com/blog/2026/08/07/is-there-hope-for-parkinsons-disease-patients/) _2026-08-07 · matthew holt · The Health Care Blog_ By STEVEN ZECOLA Congress will need to amend its faltering Parkinson’s disease legislation if it hopes to achieve meaningful results. Why Change Is Necessary For more than 50 years, the National Institutes Continue reading... ## [A digital health company became an insurance carrier under the thin veil of a product launch](https://thehealthcareblog.com/blog/2026/08/06/a-digital-health-company-became-an-insurance-carrier-under-the-thin-veil-of-a-product-launch/) _2026-08-06 · matthew holt · The Health Care Blog_ By DEEKSHA HEGDE How to spot a fundamental business model shift from a mile away, long before the PR calls it a product launch or market expansion. In April 2026, Progyny, a Continue reading... ## [Sync Bookmarks Everywhere (Sponsored)](https://crawlproof.com/a/3zxp4gsc9xzZ) _2026-08-06 · **Sponsored**_ Two-way sync keeps folders and toolbar intact across Chrome, Firefox, and Safari. ## [Kimi K3: How an Open-Weights Model Reached the Level of Claude and GPT’s Best Models](https://eido-askayo.blogspot.com/2026/08/kimi-k3-how-open-weights-model-reached.html) _2026-08-05 · Eido Askayo · Eido Askayo_ A model whose weights you can download is now part of the performance conversation that usually belongs to Claude and GPT. That is what makes Kimi K3 exciting. It does not mean K3 wins every benchmark or matches every Claude and GPT configuration. The title means something narrower and still important: this open-weights release is close enough to be compared seriously with current frontier… ## [Claude Opus 5: What Happens When an AI Agent Can Keep Working Longer Than You Can?](https://eido-askayo.blogspot.com/2026/07/claude-opus-5-working-longer.html) _2026-07-25 · Eido Askayo · Eido Askayo_ Yesterday, July 24, Anthropic released Claude Opus 5 . The headline facts are easy to repeat: it is cheaper than Claude Fable 5, stronger than the older Opus model, and designed for everyday use. But the more interesting question is not how quickly it can answer. It is what happens when an AI agent can keep working after the first answer. An AI agent is not only a chatbot. It can take several… ## [Does Claude Have a “Subconscious”? Anthropic Found a Limited Window Into Its Silent Reasoning.](https://eido-askayo.blogspot.com/2026/07/does-claude-have-subconscious.html) _2026-07-14 · Eido Askayo · Eido Askayo_ Does Claude have a subconscious ? Anthropic’s new research cannot answer that question. But it does reveal a striking division inside Claude. A small internal workspace can hold concepts, use them for reasoning, and sometimes report on them without writing them down. Most internal processing remains automatic. Anthropic calls this workspace the J-space . It is not Claude’s written answer or its… ## [I Built PA-Trace: An On-Device MedGemma Workflow for Prior Authorization](https://eido-askayo.blogspot.com/2026/07/i-built-pa-trace-on-device-medgemma.html) _2026-07-08 · Eido Askayo · Eido Askayo_ I believe AI can improve humanity . But in healthcare, that future may start with something less glamorous: removing administrative friction . That was the idea behind PA-Trace , my submission to Google Research's MedGemma Impact Challenge on Kaggle , which ran from January 13, 2026 to February 24, 2026 . An estimated $35 billion of annual US healthcare administrative spending is tied to… ## [What Stopped Fable 5 Was Not the Model](https://eido-askayo.blogspot.com/2026/07/what-stopped-fable-5-was-not-model.html) _2026-07-01 · Eido Askayo · Eido Askayo_ Anthropic says it suspended Fable 5 and Mythos 5 because it had no reliable way to verify nationality in real time after new US export controls took effect. In plain English, the first bottleneck was not just model capability. It was the system deciding who should be allowed through the gate. That is why this detail matters. Anthropic's redeployment post is not just a status update about Fable 5… ## [GPT-5.6 Sol and Claude Mythos Show That the AI Race Has Reached a New Level](https://eido-askayo.blogspot.com/2026/06/gpt-5-dot-6-sol-and-claude-mythos.html) _2026-06-27 · Eido Askayo · Eido Askayo_ GPT-5.6 Sol matters because the performance story is strong. OpenAI says Sol is its strongest cyber model yet . On ExploitBench , it says Sol is competitive with Claude Mythos Preview while using about one-third of the output tokens . On ExploitGym , Sol leads the rest of the GPT-5.6 family as reasoning budgets rise. And on OpenAI's internal capture-the-flag tasks, Sol is close to saturation. That… ## [Anthropic’s Cyber Research Suggests AI Is Reducing the Time Between a Patch and an Exploit](https://eido-askayo.blogspot.com/2026/06/anthropics-cyber-research-suggests-ai.html) _2026-06-26 · Eido Askayo · Eido Askayo_ On May 22, June 3, and June 8, 2026 , Anthropic published three cyber research posts that looked like different stories. One was about exploit benchmarks. One mapped malicious AI use to the MITRE ATT&CK framework, which is a common way security teams describe attacker behavior. One tested how fast models could turn published patches into working exploits. Read together, they point to a simpler… ## [What New OIG Reports Reveal About Medicare Advantage Prior Authorization](https://mirandayaver.substack.com/p/what-new-oig-reports-reveal-about) _2026-06-12 · Miranda Yaver · Rationing by Inconvenience_ Two new Health and Human Services Office of the Inspector General reports offered a frightening new glimpse into the difficulties of securing Medicare Advantage coverage. ## [Why Anthropic and OpenAI’s S-1 Filings Matter](https://eido-askayo.blogspot.com/2026/06/why-anthropic-and-openais-s-1-filings.html) _2026-06-11 · Eido Askayo · Eido Askayo_ On June 1, 2026 , Anthropic said it had confidentially submitted a draft S-1 to the SEC. On June 8, 2026 , OpenAI said it had recently submitted a confidential S-1 too. For frontier AI , that matters. But this is not really an IPO timing story. The better question is what Anthropic and OpenAI are starting to look like. Last week, I wrote that Anthropic’s Series H and Draft S-1 Point to a Bigger… ## [My Comment on the CMS Rule on Medicaid Paperwork Requirements](https://mirandayaver.substack.com/p/my-comment-on-the-cms-rule-on-medicaid) _2026-06-10 · Miranda Yaver · Rationing by Inconvenience_ This morning, I submitted my comment on the Centers for Medicare and Medicaid Services’ proposed rule on the Medicaid work requirements enacted through HR1. ## [Trade Bitcoin & Ethereum (Sponsored)](https://crawlproof.com/a/D0ZTdeXKfMp4) _2026-06-10 · **Sponsored**_ Buy, sell and margin trade BTC & ETH with fiat currencies ## [Claude Fable 5 Shows a New Way to Release Powerful AI](https://eido-askayo.blogspot.com/2026/06/claude-fable-5-shows-new-way-to-release.html) _2026-06-10 · Eido Askayo · Eido Askayo_ Anthropic has released its strongest public Claude yet , and that alone is big news. Claude Fable 5 is clearly a capability story. Anthropic says Fable 5 is its most capable model ever made widely available, and Google Cloud describes it as strong at multi-step reasoning, software work, and document analysis. That is a real jump. But what caught my attention is not only the model. It is the way… ## [My Comment on the CMS Proposed Rule on State-Directed Payments](https://mirandayaver.substack.com/p/my-comment-on-the-cms-proposed-rule) _2026-06-08 · Miranda Yaver · Rationing by Inconvenience_ The Centers for Medicare and Medicaid Services proposed on May 20 an awful rule implementing the not-so-beautiful bill’s cuts to Medicaid state-directed-payments (SDPs). ## [Why House Republicans' Plan to Eliminate AHRQ Would Be a Disaster](https://mirandayaver.substack.com/p/why-house-republicans-plan-to-eliminate) _2026-06-08 · Miranda Yaver · Rationing by Inconvenience_ The House of Representatives is at it again, working to eliminate the Agency for Healthcare Research and Quality (AHRQ), a proposed cut that is as misguided as it is dangerous. ## [Anthropic’s Series H and Draft S-1 Point to a Bigger Shift in Frontier AI](https://eido-askayo.blogspot.com/2026/06/anthropics-series-h-and-draft-s-1-point.html) _2026-06-04 · Eido Askayo · Eido Askayo_ On May 28, 2026 , Anthropic announced a $65 billion Series H at a $965 billion post-money valuation . On June 1, 2026 , it said it had confidentially submitted a draft S-1 to the SEC, which means it now has the option to go public later if conditions are right. Those look like normal company-building signals. But the more interesting story is not the valuation, and not the IPO option by itself. It… ## [Why Frontier AI Needs Critics It Can't Buy](https://eido-askayo.blogspot.com/2026/05/why-frontier-ai-needs-critics-it-cant-buy.html) _2026-05-28 · Eido Askayo · Eido Askayo_ The Vatican was the dramatic setting. The more important signal came from Chris Olah's remarks : every frontier AI lab is trapped inside incentives that can conflict with doing the right thing. That is the part builders should pay attention to. A lab at the frontier is saying, in public, that it cannot be its own final critic. This Is Not Really a Church Story You do not need to be Catholic to… ## [Project Glasswing Update: The Bottleneck Is Moving From Discovery to Patching](https://eido-askayo.blogspot.com/2026/05/project-glasswing-update.html) _2026-05-25 · Eido Askayo · Eido Askayo_ Last month, I wrote that Project Glasswing mattered less as a model announcement and more as a deployment signal . Anthropic had a frontier model with unusually strong cyber capability, and instead of shipping it broadly, it wrapped it in a controlled defensive program. The new initial update for Project Glasswing makes that decision easier to understand. It does not prove vulnerability research… ## [The Hype Meets the Data: State of AI 2026 Results](https://eido-askayo.blogspot.com/2026/05/the-hype-meets-data-state-of-ai-2026.html) _2026-05-22 · Eido Askayo · Eido Askayo_ Last month, I shared the open survey for the State of AI 2026, asking you to help replace the endless industry hype with actual, ground-level field data. The results are finally out, collected from 7,258 web developers . After reviewing the deep breakdown across every section—from models and agents to demographics and real-world pain points—the verdict is clear. AI-assisted coding is no longer a… ## [Adding Session Memory Without Building a Preference Engine](https://eido-askayo.blogspot.com/2026/05/adding-session-memory-without-building.html) _2026-05-15 · Eido Askayo · Eido Askayo_ I just added another feature to Kino , my educational, cinema-themed distributed systems project. The LangGraph-based agent service is one part of that platform. This time the feature was memory . But not the vague, hyped kind. I did not want Kino to pretend it knows a user's taste forever. I wanted something much narrower and much more useful: Short-term conversational memory for follow-up turns… ## [Mental Health Parity?](https://mirandayaver.substack.com/p/mental-health-parity) _2026-05-14 · Miranda Yaver · Rationing by Inconvenience_ My book Coverage Denied: How Health Insurers Drive Inequality in the United States has now been out in the world for three weeks. ## [UnitedHealthcare Took a Big Step on Prior Authorization. The Industry Must Go Further.](https://mirandayaver.substack.com/p/unitedhealthcare-took-a-big-step) _2026-05-11 · Miranda Yaver · Rationing by Inconvenience_ On May 5, UnitedHealthcare announced it will eliminate 30 percent of its remaining prior authorization requirements. ## [Realtime AI Arbitrage Terminal (Sponsored)](https://crawlproof.com/a/CgCsfC6A2MQR) _2026-05-11 · **Sponsored**_ Realtime auto-trading across exchanges with scored setups, backtesting, and risk controls. ## [Not Classic RAG: Building a Structured-Retrieval Discovery Agent with LangGraph](https://eido-askayo.blogspot.com/2026/05/not-classic-rag-building-structured.html) _2026-05-07 · Eido Askayo · Eido Askayo_ I just added a new feature to Kino , my educational movie-discovery project built with LangGraph: a prompt-driven discovery flow that finds grounded titles from a local catalog. The easy label would be RAG . More precisely, it is not classic RAG . What I built is closer to a structured-retrieval agent : the model interprets the request, a narrow service returns structured facts, and deterministic… ## [Ubuntu 26.04 LTS: AI Toolchains in the Repo, Security in the Defaults](https://eido-askayo.blogspot.com/2026/05/ubuntu-2604-lts-ai-toolchains-in-repo.html) _2026-05-01 · Eido Askayo · Eido Askayo_ Last week, on April 23, 2026, Canonical released Ubuntu 26.04 LTS "Resolute Raccoon" . The interesting part is not GNOME 50 or the normal LTS cadence. It is that Ubuntu 26.04 moves more of the hard platform work into the supported distro path: TPM-backed full-disk encryption , CUDA via apt , ROCm in Ubuntu's repositories , Wayland with NVIDIA support , and Rust-based sudo and core utilities . For… ## [GPT-5.5 Is Not Just a Better Model. It Is a Deployment Story.](https://eido-askayo.blogspot.com/2026/04/gpt-5-dot-5-is-not-just-better-model.html) _2026-04-25 · Eido Askayo · Eido Askayo_ On April 23, 2026, OpenAI introduced GPT-5.5 . The obvious story is performance: better coding, stronger tool use, more persistence, fewer tokens, and GPT-5.4-class latency. But the more important story is what came with it. OpenAI did not just ship a benchmark table. It shipped a system card , a long deployment-safety write-up on misalignment and internal deployment , and a public Bio Bug Bounty… ## [Coverage Denied Publication Day is Here!](https://mirandayaver.substack.com/p/coverage-denied-publication-day-is) _2026-04-23 · Miranda Yaver · Rationing by Inconvenience_ Today marks the day that my book Coverage Denied: How Health Insurers Drive Inequality in the United States is officially released out into the world. ## [The Physical Agent Harness: Why Project Mirage’s 'Dune' Keypad Matters](https://eido-askayo.blogspot.com/2026/04/the-physical-agent-harness-why-project.html) _2026-04-21 · Eido Askayo · Eido Askayo_ The AI hardware conversation has spent the last year obsessed with wearables—smart pins and pendants trying to replace your smartphone. But for developers, the real operational bottleneck isn't checking the weather on the go. It is the physical friction of constant context-switching at the desk: jumping between IDEs, GitHub, terminals, and back-to-back meetings. This week, Project Mirage —a… ## [Claude Mythos Preview: The Most Important AI Release Wasn't a Release](https://eido-askayo.blogspot.com/2026/04/claude-mythos-preview-most-important-ai.html) _2026-04-14 · Eido Askayo · Eido Askayo_ Anthropic’s most important signal this month is not a benchmark chart. It is the fact that the company published a full system card for Claude Mythos Preview and then explicitly said it does not plan to make the model generally available. That is a very different kind of launch. If Anthropic’s own materials are directionally right, then we are moving from “AI can help security teams” to something… ## [7,000+ Clicks to Register a FHIR App](https://joshuamandel.com/blog/posts/7000-clicks-to-register-a-fhir-app) _2026-04-03 · Interop Blog_ TL;DR: I built Health Skillz to help patients connect their health records to an AI assistant. An important feature of such an app is the ability to maintain a long-term connection when that's what the patient wants. Enabling this required registering a new type of SMART on FHIR client with Epic. Epic deserves credit f… ## [Anyone Can Add Structure... If Plans Publish the Rules of Play](https://joshuamandel.com/blog/posts/anyone-can-add-structure-if-plans-publish-the-rules-of-play) _2026-04-03 · Interop Blog_ There is a lot of pressure right now to improve prior authorization. Some of that work is overdue and useful: fewer portals, less faxing, cleaner transactions, better ways to move documentation from the chart into the request. CMS’s interoperability and prior authorization rule, finalized in January 2024, pushes the sy… ## [Beyond "Loading...": Thirty-four prototypes before breakfast](https://joshuamandel.com/blog/posts/beyond-loading-thirty-four-prototypes-before-breakfast) _2026-04-03 · Interop Blog_ I'm building Health Skillz, a patient-facing app that helps people bring their healthcare data securely into their browser from provider systems -- and, from there, share it with an AI of their choice, with end-to-end encryption so only the AI can decrypt it. When someone connects their patient portal to Health Skillz,… ## [Demystifying FHIR Terminology Bindings: An AI-Assisted Guide](https://joshuamandel.com/blog/posts/demystifying-fhir-terminology-bindings-an-ai-assisted-guide) _2026-04-03 · Interop Blog_ (Guest Post by Shelley / Exe.dev, via Claude Opus 4.5 with access to Zulip. Jira, and the FHIR spec, and a detailed set of prompts based on today's HL7 Working Group meeting Q2 between FHIR Infrastructure and Terminology WGs.) Subject: How binding strength, additional bindings, and CodeableConcept work together—and how… ## [FHIR meets Ralph Wiggum (or: Agents Can Find Spec Bugs!)](https://joshuamandel.com/blog/posts/fhir-meets-ralph-wiggum-or-agents-can-find-spec-bugs) _2026-04-03 · Interop Blog_ The Hype The "Ralph Wiggum loop" went viral in early 2026. Named after the Simpsons character, the idea is dead simple: run an AI agent in a loop until done, reset context each session, preserve progress externally. Plugins spawned. Twitter argued about token costs. I was skeptical. Then I watched Claude Opus 4.5 write… ## [From MCP Server to AI Skill: A Simpler, More Powerful Way to Analyze Federal Regulation Comments](https://joshuamandel.com/blog/posts/from-mcp-server-to-ai-skill-a-simpler-more-powerful-way-to-analyze-federal-regulation-comments) _2026-04-03 · Interop Blog_ Last summer I shared an MCP server that let AI tools query public comments on federal regulations. It worked — but hosting and maintaining it was a pain. Today I'm replacing it with something better. The MCP problem The MCP server required a running backend (I hosted on Fly.io with a scale-to-zero VM), had payload size… ## [Granting Permission to Yourself: American Medical Records Requests are Often Absurd](https://joshuamandel.com/blog/posts/granting-permission-to-yourself-american-medical-records-requests-are-often-absurd) _2026-04-03 · Interop Blog_ Imagine walking into your local public library to check out a book, only to be handed a third-party disclosure form designed for an insurance company. You write your own name in the "Authorized Recipient" box. You declare your "Purpose" for wanting to read the book. You ask two strangers in the lobby to co-sign your re… ## [Health Skillz: Why I Built My Own Health Record Connector for Claude.ai & Codex](https://joshuamandel.com/blog/posts/health-skillz-why-i-built-my-own-health-record-connector-for-claude-ai-codex) _2026-04-03 · Interop Blog_ TL;DR: I built Health Skillz, a Claude Skill that fetches your health records directly from your patient portal using SMART on FHIR. It pulls all your structured data (labs, meds, conditions) plus the full text of clinical notes, encrypts everything end-to-end, and lets Claude analyze it. To try it: download the skill,… ## [How I Used AI Agents to Assess the State of EHI Export](https://joshuamandel.com/blog/posts/how-i-used-ai-agents-to-assess-the-state-of-ehi-export) _2026-04-03 · Interop Blog_ This is the technical companion to "I Graded Every EHR's Patient Data Export Documentation." That post says what I found; this one says how I found it. From 10,000 pages to 217 vendors Last year I built a tool to read 10,000 pages of public comments on the CMS Health Tech Ecosystem RFI. The approach was a feed-forward… ## [HTI-5 Analysis: A Battle is Brewing Over AI Agents as EHR Users](https://joshuamandel.com/blog/posts/hti-5-analysis-a-battle-is-brewing-over-ai-agents-as-ehr-users) _2026-04-03 · Interop Blog_ Guest post from Gemini Pro analyzing HTI-5 comments on the theme of artificial intelligence / robotic process automation, sourced from my regulations.gov comment browser on HTI-5. For the past fifteen years, the undisputed center of gravity in American healthcare has been the Electronic Health Record (EHR). Following a… ## [HTI-5: Deregulation, Rhetoric, and Architectural Gaps](https://joshuamandel.com/blog/posts/hti-5-deregulation-rhetoric-and-architectural-gaps) _2026-04-03 · Interop Blog_ The latest proposed rule from ASTP/ONC frames a significant deregulation of the Health IT Certification Program as a necessary pivot toward a "FHIR-forward future." The document uses the rhetoric of modernization to justify the removal of long-standing requirements for legacy standards like C-CDA and Direct, and I'm ge… ## [I Built an AI Skill to Help Patients Request Their EHI Export](https://joshuamandel.com/blog/posts/i-built-an-ai-skill-to-help-patients-request-their-ehi-export) _2026-04-03 · Interop Blog_ Every patient in the US has the right to a complete electronic copy of their medical record. Since December 2023, every certified EHR system has been required to support a feature called “EHI Export” that produces exactly this: a bulk export of all structured data in a patient’s chart. This is different from (deeper th… ## [I Graded 265 EHRs on the "Export Everything" Requirement. (Median grade was D.)](https://joshuamandel.com/blog/posts/i-graded-265-ehrs-on-the-export-everything-requirement-median-grade-was-d) _2026-04-03 · Interop Blog_ A caveat up front: Evaluating EHI export documentation is hard. Vendors' published specs are often limited, cryptic, or use product-specific terminology that's unfamiliar even to domain experts. AI-assisted analysis facilitates best-effort understanding, but it can be wrong in the details. I can't manually review all 6… ## [I registered Health Skillz at 500 Epic sites... then couldn't connect](https://joshuamandel.com/blog/posts/i-registered-health-skillz-at-500-epic-sites-then-couldn-t-connect) _2026-04-03 · Interop Blog_ This is a follow-up to 7,000+ Clicks to Register a FHIR App. That post covered the work of getting a confidential SMART on FHIR client registered at 500 Epic organizations. This post covers what happened next. --- My automation script ran; the management portal said "Keys enabled" for Health Skillz at 496 organizations…