June 24th, 2025 – Insurers across the country announced a pact to reform the process for Prior Authorizations, to make it faster and easier for healthcare consumers to get the care they need. Because every insurer had a different process, it created quite an administrative burden on providers, in addition to the frustration it can cause patients.
The pledge includes both commercial plans, Medicare plans and some managed care Medicaid plans and is expected to help 257 million Americans reduce red tape and streamline the Prior Authorization process.
The Colorado insurance companies who signed the pledge include Aetna, Elevance Health / Anthem Blue Cross Blue Shield, Cigna, Kaiser Permanente and UnitedHealthcare.
The Department of Health and Human Services and AHIP said six key areas will be improved:
- Reduce the number of medical services that require prior authorization.
- Minimize delays with real-time approvals for most requests.
- Standardize electronic prior authorization submissions.
- Honor existing authorizations when patients change insurance plans in the middle of ongoing treatment.
- Enhance transparency and communication about authorization decisions and appeals.
- Ensure medical professionals review all clinical denials.
The new rules for prior authorization are to be phased in over the next year and a half.
Most customers of Medicare Advantage plans need prior authorization for many services and most HMO and EPO plans require Prior Authorization for many services.
