Major Health Insurers Commit to Faster, Simpler Prior Authorization Process

by Tom Ozimek, The Epoch Times.com, June 23, 2025

A coalition of major U.S. health insurers has pledged to overhaul the often-criticized prior authorization process, committing to reducing administrative delays and improving access to care for more than 250 million Americans enrolled in commercial, Medicare Advantage, and Medicaid managed care plans.

Unveiled on June 23 by the trade association America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association, the initiative introduces a set of industry-wide commitments aimed at modernizing and streamlining how insurers review and approve medical treatments and services. The reforms focus on improving timeliness, enhancing transparency, and adopting advanced technologies to ease burdens on patients and providers alike.
 

At a June 23 news conference discussing the health industry commitments, Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said the issue of prior authorizations has turned into a major barrier to timely patient care, forcing doctors to spend hours navigating red tape instead of treating patients.

Each week, on average, a physician handles about 40 of these preauthorization issues and requests and spends about 12 hours a week on paperwork in general, often aimed at addressing the prior authorization issue,” Oz said. “It frustrates doctors. It sometimes results in care that is significantly delayed. It erodes public trust in the health care system. It’s something we can’t tolerate.”

Health Secretary Robert F. Kennedy Jr. thanked insurance companies for making the commitment, saying the Trump administration is “actively working with industry to make it easier to get prior authorization for common services such as diagnostic imaging, physical therapy, and outpatient surgery.”

Prior authorization, a tool used by insurers to verify that treatments and prescriptions are medically appropriate and supported by clinical guidelines, is intended to prevent unnecessary, duplicative, or potentially harmful care. According to an AHIP report, roughly 25 percent of U.S. health care spending is considered wasteful—driven by overtreatment, inefficiency, and lack of care coordination. Patients and health care professionals have long criticized the prior authorization process for causing delays and confusion, especially when insurers rely on outdated manual systems.

“The healthcare system remains fragmented and burdened by outdated manual processes, resulting in frustration for patients and providers alike,“ AHIP President and CEO Mike Tuffin said in a statement. ”Health plans are making voluntary commitments to deliver a more seamless patient experience and enable providers to focus on patient care, while also helping to modernize the system.”

The initiative—outlined in a June 23 statement posted by AHIP—involves a number of core commitments aimed at making the prior authorization process faster, simpler, and more patient-friendly.

First, insurers plan to create a standardized electronic system for submitting and reviewing prior authorization requests, which is expected to be in place by Jan. 1, 2027. The goal is to make the process more consistent, easier to understand, and faster to complete.

Second, health plans will reduce the number of medical services and treatments that require prior authorization. Each insurer will set specific targets based on the needs of its local market, with reductions expected by Jan. 1, 2026.

Third, insurers will help protect patients who are in the middle of treatment and need to change health plans. Starting in 2026, new plans will honor previous approvals for up to 90 days, as long as the treatment is covered and the provider is in-network.

Fourth, health plans will make it easier for patients to understand prior authorization decisions. By 2026, plans will provide clearer, more personalized explanations for any denials, along with step-by-step guidance on how to appeal.

Fifth, insurers have committed to making faster decisions on electronic prior authorization requests thanks to investments in updated technologies that allow for quicker, automated reviews. By 2027, they plan to provide immediate approvals for at least 80 percent of requests.

Finally, insurers have reaffirmed an already existing safeguard requiring decisions to deny care for medical reasons to always be reviewed by health care professionals. While technology may help speed up approvals, it will not be used to reject requests without a doctor’s review, according to the AHIP.

Kim Keck, president and CEO of the Blue Cross Blue Shield Association, called the reforms a “meaningful step forward” and an “important foundation” for addressing deeper challenges in the U.S. health care system.

Shawn Martin, executive vice president and CEO of the American Academy of Family Physicians, welcomed the announcement, but cautioned that the success of the initiative will depend on real-world results.

“While this commitment is a step in the right direction, we will ultimately measure its impact by real changes in the day-to-day experiences of patients and the physicians who care for them,“ Martin said in a statement. ”We look forward to collaborating with payers to ensure these efforts lead to meaningful and lasting improvements in patient care.”

Insurers that have signed on to the commitment include many of the nation’s largest carriers, such as UnitedHealthcare, CVS Health’s Aetna, Cigna, Humana, Elevance Health, and Kaiser Permanente, along with dozens of regional and state-based Blue Cross Blue Shield plans.
 

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