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Health Insurers Pledge to Streamline Prior Authorization Process by 2027
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Health Insurers Pledge to Streamline Prior Authorization Process by 2027
Jun 23, 2025 5:31 AM

08:09 AM EDT, 06/23/2025 (MT Newswires) -- America's Health Insurance Plans, a trade group representing health plans, said Monday that CVS Health ( CVS ) , UnitedHealthcare (UNH), Cigna ( CI ) , Humana (HUM), and Elevance Health ( ELV ) are among health insurers committing to overhaul prior authorization processes by 2027.

The aim is to reduce administrative delays and improve access to care for 257 million Americans across commercial, Medicare Advantage, and Medicaid markets, AHIP said.

Participating insurers will implement standardized electronic prior authorization using FHIR APIs by Jan. 1, 2027, and reduce the number of procedures requiring prior approval by Jan. 1, 2026, the trade group said.

AHIP also said that insurers will honor active authorizations for 90 days when patients change plans and will provide clearer explanations of decisions by Jan. 1, 2026.

80% of electronic requests will be processed in real-time starting in 2027, and clinical professionals will continue reviewing all medical denials, the organization said.

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