Going into 2026, prior authorization continues to be a contentious topic for payers, providers, lawmakers and other leaders. From piloting prior authorization in Medicare to governors pitching reforms, this year is bound to feature significant shifts.
Here are five prior authorization updates in 2026, so far:
1. Ninety-three percent of health plan executives expect AI to add value by automating prior authorizations, according to an analysis of Deloitte survey results released Jan. 15.
2. On Jan. 14, Massachusetts Gov. Maura Healey pitched 24-hour turnaround times for urgent prior authorization requests and eliminating prior authorization for certain conditions, along with other reforms. She also shared the Health Care Affordability Working Group, which will include Blue Cross Blue Shield of Massachusetts President and CEO Sarah Iselin and Massachusetts Association of Health Plans President and CEO Lora Pellegrini.
3. Just a day prior, New York Gov. Kathy Hochul also proposed a handful of healthcare initiatives for her state, including reforms for prior authorization. Under her pitch, prior authorizations for some chronic conditions would last longer, the state would run a public education campaign for consumers and providers, and some data sharing would be required.
4. A series of state laws across North Dakota, Nebraska and Alaska went into effect at the top of 2026, pushing insurers to quicken prior authorization response times.
5. CMS’ Wasteful and Inappropriate Service Reduction initiative also kicked off this year, with providers in Arizona, Washington, New Jersey, Texas, Ohio and Oklahoma piloting the new protocol. For the first time, traditional Medicare faces prior authorization requirements.
