WASHINGTON, D.C. – Health and Human Services Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced that several major health insurance companies have agreed to change how they handle prior authorization — the process that requires patients to get approval before receiving certain medical services.
The agreement was made during a meeting with top insurance companies in Washington, D.C. The changes aim to reduce delays and paperwork for patients and doctors.
Companies taking part include Aetna, Cigna, UnitedHealthcare, Blue Cross Blue Shield, Humana, and others. These insurers provide coverage to most Americans through Medicare Advantage, Medicaid, the Health Insurance Marketplace®, and other private plans.
The insurers agreed to:
- Use the same electronic system for submitting and handling prior authorization requests.
- Reduce the number of services that require prior authorization by January 1, 2026.
- Honor prior approvals when patients switch insurance plans.
- Improve communication about denied requests and how to appeal them.
- Speed up decisions, with most requests answered in real-time by 2027.
- Ensure medical professionals review all denied services.
Secretary Kennedy said patients should not have to struggle with insurers to get care. Administrator Oz said the changes are a step toward reducing delays and improving trust in the system.
HHS and CMS plan to monitor progress. If improvements are not made, federal officials may consider new rules to require changes.
Lawmakers who attended the meeting supported the effort and said current delays in care caused by prior authorization are a widespread concern for both patients and healthcare providers.