Insurers Pledge to Improve Prior Authorization
In June 2025, over 60 major health insurers—including UnitedHealthcare, Aetna, Cigna, Humana, Elevance Health, and the Blue Cross Blue Shield Association plans—pledged to streamline the prior authorization process.
The pledge includes six key commitments:
- Standardize electronic prior authorization requests.
- Reduce the number and scope of services that require a request.
- Boost care continuity when patients change health plans.
- Explain denials and provide instructions for appeals.
- Accelerate approval response times for patients and physicians.
- Ensure all denials based on medical necessity continue to be reviewed by a licensed and qualified clinician.
Insurers have long promised reforms to prior authorization. For meaningful, lasting change we need to hold them accountable.
A History of Promises
2018
National organizations representing health care professionals and health plans sign a Consensus Statement promising to improve prior authorization, outlining five key areas for meaningful action: selective use of prior authorization, program review and volume adjustment, transparency and communication, continuity of patient care, and automation to boost efficiency.
Unfortunately, surveyed physicians report observing little progress in achieving the reforms agreed to in the Consensus Statement.
2023
Several large insurers, including UnitedHealthcare and Cigna Healthcare, announce plans to cut back on prior authorization requirements. UnitedHealthcare announces plans to eliminate nearly 20% of procedure codes and introduce a “gold card” program, and Cigna states its intention to remove about 25% of medical services from prior authorization requirements.
Unfortunately, only 16% of surveyed physicians who work with UnitedHealthcare and 16% of physicians who work with Cigna report that these changes have reduced the number of prior authorizations completed for these plans.
2025
Major insurers pledge to streamline prior authorization by reducing approval requirements, expanding electronic submissions, and improving transparency within the system. The pledge includes an immediate commitment that all prior authorization denials based on medical necessity will be reviewed by a licensed and qualified clinician.
2026
By January 1, 2026, insurers promise to reduce procedures requiring prior authorization, honor approvals for 90 days when patients switch plans, and clearly communicate denial explanations and appeal options to patients.
2027
By January 1, 2027, insurers commit to implementing a standardized, streamlined electronic prior authorization process. In addition, insurers pledge that 80% of electronic prior authorization approvals will be processed in real time by January 1, 2027.
The AMA will continue to track progress and hold insurers accountable for following through on their pledge.