7 payers cutting prior authorization requirements

Several payers are scaling back their prior authorization requirements in an effort to ease administrative burdens on providers. 

Major payers, including UnitedHealthcare and Cigna, have removed prior authorization requirements in the past year. 

Some insurers, including UnitedHealthcare, have also moved to expand gold card programs, which ease prior authorization requirements for contracted providers whose requests are routinely approved. 

Here are seven payers that have scaled back prior authorizations in the past year: 

1. L.A. Care Health Plan removed 24% of its prior authorization requirements. The largest publicly operated health plan in the country, no longer requires prior authorization for most specialty visits, and around 50% of lab and radiology codes, durable medical equipment and catheters. 
   
   
2. Blue Cross and Blue Shield of Rhode Island will eliminate nearly 65% of prior authorization requirements for primary care providers by early 2025. 
   
   
3. Point32Health no longer requires prior authorization for home care for the first 30 days after one of the company's commercial beneficiaries is discharged from a hospital.
   
   
4. Blue Cross Blue Shield of Massachusetts will remove 14,000 prior authorization requirements for home care services in response to the capacity crisis in the state's hospitals. 
   
   
5. Blue Cross Blue Shield of Michigan intends to cut 20% of its prior authorization requirements. 
   
   
6. UnitedHealthcare eliminated 20% of its prior authorization requirements over two waves in September and November 2023. 
   
   
7. Cigna Healthcare removed prior authorization requirements for more than 600 medical procedures, cutting the number of prior authorizations it requires by 25%.