From payers announcing commitments to reduce prior authorizations to Alaska lawmakers passing a reform bill, here are six updates on prior authorization that Becker’s has reported since June 23:
1. The broader health insurance industry announced a series of commitments to streamline, simplify and reduce prior authorization requirements across commercial, Medicare Advantage and managed Medicaid plans covering 257 million Americans.
2. Ahead of the health insurance industry’s broader pledge to overhaul prior authorization processes, one Texas payer has already achieved a 7% prior authorization denial rate, with 100% of those denials upheld upon appeal.
3. CMS unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative that will add prior authorization for some traditional fee-for-service Medicare services.
4. A new Alaska law takes effect on Jan. 1, 2026, that requires faster responses to prior authorization requests for certain treatments and services.
5. Humana is accelerating its efforts to reform the prior authorization process through a series of new policies, including eliminating one-third of prior authorization requirements for outpatient services and launching a gold card program. The changes are set to take effect in 2026.
6. A majority of adults say they haven’t heard anything about the industry’s latest reform initiative, nor do they expect it to make a real impact, according to a KFF Health Tracking Poll.
