"We're making meaningful progress on improving the prior authorization process. ... With many improvements going live in January, we remain committed to streamlining processes and reducing the scope of requirements to improve the experience for patients and providers,"
"Any step toward reducing prior authorization is welcome, and family physicians have been asking for relief for years,"
"From where we sit in exam rooms, commitments alone aren't sufficient. Prior authorization still eats up an enormous amount of time and causes real delays in care; nearly 90% of physicians say it's extremely burdensome. Until we see meaningful changes that actually reduce paperwork and speed up approvals, patients and physicians will continue to feel the strain."
More than 50 health plans, including UnitedHealthcare, Aetna, Cigna and several Blues plans, made commitments with CMS to simplify prior authorization. Commitments include clearer explanations of determinations, faster turnaround times and continuity of care when patients switch plans. Several changes will begin in 2026 and others in 2027. A Blue Cross Blue Shield Association representative said many improvements will go live in January and emphasized commitments to streamline processes and reduce requirement scope. Providers express cautious optimism but say prior authorization remains highly burdensome, consuming significant time and causing delays until paperwork and approval speed improve.
Read at MedCity News
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