Humana will eliminate approximately one-third of its prior authorization requirements for outpatient services by January 1, 2026, to expedite care and reduce administrative burdens for healthcare providers. The changes focus on frequent diagnostic services. Humana aims to improve decision times, committing to provide decisions within one business day for 95% of electronic requests. A new gold-card program will exempt providers with a proven record from prior authorization requirements. This initiative is expected to influence broader industry standards and enhance patient experiences across the healthcare system.
On July 22, 2025, Humana announced it would eliminate approximately one-third of prior authorization mandates for outpatient services by January 1, 2026, aiming to improve patient care.
Humana is committing to greater transparency regarding prior authorization as it faces pressure to reform controversial pre-approval protocols that frustrate patients and providers.
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