Becker's Healthcare February 5, 2025
Prior authorization reforms remain a major advocacy priority for provider trade groups in 2025, and several state lawmakers have also introduced legislation to bring changes to the process.
The American Hospital Association said that commercial health insurers should be held accountable for ensuring appropriate access to care, including by reducing the “excessive use of prior authorization.” The group is also seeking to reduce administrative burdens that “take clinicians away from the bedside and contribute to burnout, such as excessive and unnecessary prior authorization use and inappropriate coverage denials that require substantive clerical rework by staff.”
The Medical Group Management Association is seeking to eliminate or significantly reduce the volume of prior authorizations and other prerequisites for coverage.
“There...
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