Top 5 Changes Coming from Insurers’ Prior Authorization Reform Pledge

Nearly seven months following the tragic shooting of an insurance CEO in New York that highlighted health insurers’ tendency to deny or delay necessary care, major U.S. insurers, including Cigna, Aetna, Humana, and UnitedHealthcare, announced significant changes on Monday. These insurers are set to simplify their cumbersome preapproval systems by reducing the number of medical procedures requiring prior authorization and accelerating the review process. Additionally, they will commit to clearer communication with patients and ensure that medical professionals evaluate coverage denials.While officials from the Trump administration applauded these amendments, they underscored the agreement's limitations. Key health officials, including Mehmet Oz, advocate for the removal of preapproval for certain common procedures. Nevertheless, health policy experts caution that prior authorization may still hinder timely treatment for many patients. Consumer advocates remain skeptical about the substantive changes, noting that past commitments from insurers have fallen short. Uncertainties remain as exact details about implementation and services exempt from preapproval are yet to be fully disclosed.