July 1, 2025
🚨 Big News: HHS & Insurers Unite to Fix Prior Authorization!
HHS Secretary Robert F. Kennedy Jr. announced that nearly 50 major insurers — including Blue Cross Blue Shield, Cigna, Humana, UnitedHealthcare, and others — are voluntarily committing to overhaul prior authorization, making it simpler, faster, and more transparent.
🩺 What’s Changing?
📌 Prior Authorization = insurer permission before care
⏳ Known for delays and red tape
🔑 6 Insurer Commitments:
- 📲 Standardize electronic prior auth submissions
- ✂️ Reduce services needing prior auth
- 🔁 Honor approvals when patients switch plans
- 🔍 Transparency in decisions and appeals
- ⚡ Faster approvals — real-time when possible
- 👩⚕️ Medical professionals to review all denials
📅 What’s Next?
- By Jan 1, 2026: Fewer procedures will require prior auth
- By Jan 1, 2027: Full implementation of electronic standards
- Approvals valid 90 days when switching insurers mid-treatment
- CMS to release full list of insurers this summer (covering ~75% of U.S. patients)
👀 Why It Matters:
- Cuts down delays for patients
- Reduces admin burden for doctors
- Increases fairness & clarity in insurance decisions
- Not a federal mandate — yet — but signals major industry reform
📞 Questions or need help navigating prior auth changes?
Call us at (520) 721-4848
