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Health insurers to work on easing prior authorization requirements, AHIP says
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Health insurers to work on easing prior authorization requirements, AHIP says
Jun 23, 2025 4:50 AM

June 23 (Reuters) -

America's Health Insurance Plans said on Monday that U.S.

health insurers will take additional measures to simplify their

requirements for prior approval on medicines and medical

services.

Health insurers will work to develop standardized data and

submission requirements for electronic prior authorization by

January 1, 2027, the industry trade group said in a statement.

The firms will also work on reducing the scope of claims

that require prior authorization by January 1, 2026, and ensure

the authorizations are valid for a 90-day period if the patient

changes insurance companies during the course of treatment.

U.S. Health and Human Services Secretary Robert F. Kennedy,

Jr. and Centers for Medicare and Medicaid Services Administrator

Mehmet Oz are scheduled to discuss health insurance reforms in a

press conference later in the day.

"The health care system remains fragmented and burdened by

outdated manual processes, resulting in frustration for patients

and providers alike," AHIP CEO Mike Tuffin said.

Separately, CVS Health's ( CVS ) insurance unit Aetna

announced a series of measures on Monday.

This included the move to bundle multiple authorization

requests into one upfront approval for people with lung, breast

or prostate cancer who need such authorizations for MRI or CT

scans.

The killing of the head of UnitedHealth's ( UNH ) insurance

unit last year had ignited significant social media backlash

from Americans struggling to receive and pay for medical care.

UnitedHealth ( UNH ) had said in March it would ease requirements to

get insurance authorization when renewing prescriptions on about

80 drugs, aiming to eliminate up to 25% of reauthorization

requirements.

(Reporting by Mariam Sunny in Bengaluru)

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