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US Health Plans Roll Out Major Reforms Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. In a significant move to address one of the most criticized aspects of U.S. health care, the nation's leading health insurers — including UnitedHealthcare and CVS Health's Aetna — announced Monday that they will scale back and streamline the widely disliked practice of prior authorization, which has long been blamed for delays and complications in patient care. The companies plan to reduce the number of health care claims that require prior authorization, standardize electronic processes, and expand real-time decision-making for requests. They also committed to honoring approvals issued by previous insurers for a period after patients switch health plans. Why It Matters Prior authorization requires health care providers to obtain insurer approval before covering a service, such as an imaging exam or a prescription. Insurers argue the practice helps prevent overuse and ensures appropriate treatment. But many doctors say the process has become overcomplicated and overly expansive, frequently delaying necessary care. What To Know Dr. Mehmet Oz, during his March Senate confirmation hearing for the role of CMS administrator, condemned the practice as "a pox on the system" that increases administrative costs. Dr. Ashley Sumrall, an oncologist in Charlotte, North Carolina, said she has witnessed a rise in prior authorization requirements
Monday, 06/23/2025, Video Clip |
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