Health insurers are reporting progress on their voluntary effort to streamline prior authorization. They say they are on track to standardize the process for submitting prior authorization requests for coverage for many common procedures by Jan. 1, 2027.
The push, led by America’s Health Insurance Plans and supported by major carriers, aims to standardize how prior authorization requests are submitted and reviewed across commercial plans, Medicare Advantage and Medicaid-managed care. Currently, prior authorization rules are inconsistent, even within a single insurer’s operations, and providers have for years bemoaned how authorization delays endanger patients.
Insurers say the goal is to reduce the number of procedures that require prior authorization and to make decisions more quickly on approvals or denials.
Under the initiative, insurers will begin applying common electronic submission standards to frequently reviewed services, such as orthopedic procedures and imaging likeCT scans and MRIs, with broader adoption targeted by Jan. 1, 2027.
Whatinsurers say they’ve accomplished so far
Several large carriers have disclosed their own progress since a 2025 pledge to reform prior authorization:
- UnitedHealth Group said more than half of its prior authorization volume already follows standardized processes, with a goal of reaching about 70%. The company also said it plans to expand standardization to additional services and reduce the need for repeated requests.
- Cigna reported it has reduced prior authorization volume by about 15% and expects more than 70% of its reviews to fall under the new standards.
- CVS Health, through its Aetna unit, said it has already standardized roughly 88% of its prior authorization volume.
- Across participating insurers, industry groups said prior authorization requirements have been reduced by about 11% so far, though reporting methods differ by company.
Other insurers participating in the effort include Elevance Health, Humana, Kaiser Permanente and various Blue Cross andBlue Shield affiliates.
Insurers say standardizing electronic submissions should reduce delays caused by incomplete paperwork and cut down on back-and-forth between providers and health plans.
Why this matters for employers
For employers that sponsor health plans, prior authorization has been a persistent pain point for their employees. Delays in approvals can disrupt care, affect productivity and lead to employee complaints.
If the changes work as insurers describe, employees could receive faster decisions and face fewer administrative hurdles when seeking care. Employers, however, may need time to assess whether faster approvals will translate into higher utilization and increased claims costs.
Limits and ongoing concerns
Despite the reported progress, the initiative has notable gaps. The commitments are voluntary and not all insurers have set clear targets for reducing prior authorization requirements. In addition, reforms largely focus on medical services and do not yet fully address prescription drug approvals, which makeup a significant share of requests.
Health plans continue to defend prior authorization as a tool to control unnecessary or overly expensive care. Providers, meanwhile, argue that requirements are often excessive, slow and inconsistent across insurers.
For now, insurers are making incremental improvements like standardized data and reducing the number of procedures that require prior approval. Policymakers and regulators continue to weigh whether more formal rules are needed.
