HHS Unveils Initiative to Streamline Prior Authorization Processes by 2027
AHA
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Contributed by: Kate Gamble
Summary
The Department of Health and Human Services (HHS) has launched an initiative to streamline the prior authorization process, working with multiple health insurance companies that cover Medicare Advantage, Medicaid managed care, Health Insurance Marketplace, and commercial plans. The initiative aims for standardization of electronic prior authorization requests by 2027, with an objective to enhance efficiency and transparency. Insurers are expected to provide real-time responses by 2027 and reduce prior authorization requirements for common procedures like colonoscopies and cataract surgeries by 2026. HHS Secretary Robert F. Kennedy Jr. noted that the initiative's structured framework, which includes clear standards and oversight, aims to enable accountability and measurable progress in reforming the prior authorization process.
