HHS, Insurers Pledge Prior Authorization Reform Covering 257 Million Americans

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz announced a major commitment from leading health insurers to streamline and improve prior authorization processes affecting nearly 80% of Americans. The reforms include standardizing electronic prior authorization submissions, reducing the number of medical services requiring prior approval by 2026, honoring existing authorizations during insurance transitions, and expanding real-time responses to minimize care delays by 2027. Participating insurers, including Aetna, Blue Cross Blue Shield, UnitedHealthcare, Humana, and Kaiser Permanente, pledged to enhance transparency and ensure medical professionals review all clinical denials. These changes aim to cut red tape, accelerate care decisions, and improve communication with patients and providers, addressing widespread delays in healthcare access. Secretary Kennedy emphasized the importance of eliminating barriers that pit patients and doctors against insurers, while Administrator Oz highlighted the voluntary nature of these industry actions and CMS's role in monitoring progress and accountability. The initiative is expected to benefit around 257 million Americans by easing administrative burdens across commercial, Medicare Advantage, and Medicaid managed care plans.