Aetna is bundling pharmacy prescriptions and medical procedures into a single clinical review, according to a Dec. 4 news release.
Providers previously had to submit two prior authorizations, but, as of November, providers only have to file one medical review, and the associated medications under the Aetna pharmacy benefit are automatically approved.
Aetna also shared its musculoskeletal prior authorization bundle, which includes X-rays, knee arthroplasty surgical procedures, antinausea and nonopioid pain medications, inpatient admission, infection control, and medical equipment.
“Working in partnership with stakeholders across the industry, I am optimistic that we can achieve our shared purpose of simplifying the healthcare system to make it easier for consumers to navigate and access affordable, personalized solutions,” Aetna President Steve Nelson said.
In 2023, The Wall Street Journal reported that Aetna, alongside other insurers, was aiming to simplify and automate its prior authorizations.
Aetna also shared how it is piloting a conversational AI function in its Aetna Health app, which will be more widely available in early 2026.
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