Becker's Healthcare December 23, 2025
Prior authorization was a hot topic in 2025, from insurers pledging reforms to a Medicare pilot on the horizon.
Here are five of the biggest stories on prior authorization from 2025:
1. Payers have been working toward meeting requirements for CMS’ Advancing Interoperability and Improving Prior Authorization Final Rule, but progress is still lagging ahead of the 2027 deadline. The rule includes insurers implementing an application programming interface and documenting prior authorization metrics.
2. Evry Health CEO and co-founder Chris Gay suggested that axing prior authorizations could be possible. He said Evry has thought about expanding gold carding, which hinges on strengthening relationships with providers.
3. CVS Health’s Aetna is merging prescriptions and surgical procedures into a...
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