How 3 payers are easing prior authorization red tape

Three health insurance companies have cut prior authorization requirements since Aug. 24:

1. Blue Cross Blue Shield of Michigan announced a new effort to reduce prior authorization requirements by 20 percent. 

To accelerate a reduction in prior authorization requirements, it also plans to expand its "gold card" program, which aims to streamline prior authorizations for physicians with a track record of making appropriate prior authorization requests. 

Approved physicians will be exempt from the third-party prior authorization approval process.

2. UnitedHealthcare began its two-phase approach to eliminating prior authorization requirements. The new rule aims to eliminate prior authorizations planwide by 20 percent. Codes were eliminated for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plans. 

The elimination includes codes for major procedures across various specialties, including gastroenterology and spinal care.  

3. Cigna Healthcare removed nearly 25 percent of medical services from prior authorization requirements, cutting more than 600 codes. Since 2020, Cigna has removed more than 1,100 medical services with the intent to simplify healthcare for customers and clinicians.

Cigna also plans to remove 500 additional codes for Medicare Advantage plans later this year.

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