Facing widespread criticism, health insurance companies are committing to revamp their prior authorization (preapproval) procedures in an effort to reduce patient delays and administrative headaches.
Under the new plan, insurers will adopt shared electronic standards and aim to respond to 80% of complete digital prior authorization requests in real time by 2027, provided all necessary documentation is included. They’ll also enhance clarity on why requests are denied, streamline the appeals process, and introduce a 90-day continuation of care when patients switch plans.
This initiative is a response to mounting backlash—exemplified by the 2024 death of a UnitedHealth Group executive—and growing concern from healthcare providers. Many physicians report spending significant time and hiring staff just to navigate complex, often inconsistent, preapproval systems.
However, critics caution that it may not go far enough. While insurers say prior authorization helps curb unnecessary treatments and costs, no firm targets have been set for reducing the number of procedures requiring sign-off, and continued reliance on AI decision-making remains a concern.
Already, insurers like Aetna and Cigna have begun rolling out updates to improve transparency, such as letting patients track the progress of their approvals.
This sector-wide pledge marks a hopeful shift toward simplifying a formerly burdensome process. But until measurable reductions in approvals and faster decision times are achieved, ongoing oversight and pressure—from both regulators and patients—will be essential.