One great thing that I'm excited for that Kennedy is taking care of... insurance prior authorization issues! If you ever had to go through that mess, I feel for you!! I was so stressed before my cancer surgery because the authorization for some tests were slow in getting approved!!! Now, even though prior authorization isn't going away, it will be more streamlined and insurance carriers promise to be more efficient and in some cases will waive the prior authorizations! I don't know why they just can't trust that the medical professionals know what they're doing when they request tests, meds and surgeries for their own patients!
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Insurance prior authorization to change
- Thread starter KO896
- Start date
What specific "promises" are insurance carriers making to be more streamlined? I find this to be a load of horse shit. Working in the healthcare field and dealing with PA's for medications, imaging, surgical procedures, I know how convoluted this requirement is. It doesn't seem like there's anything insurance companies can do to make it more streamlined at this point aside from getting rid of insurance companies themselves and letting MEDICAL PROFESSIONALS decide on what their patients need.
Don't get your hopes up just yet. Until privatized insurance goes away, nothing will ever be 'streamlined'.
Don't get your hopes up just yet. Until privatized insurance goes away, nothing will ever be 'streamlined'.
Here is what HHS plans to have happen:
Participating health insurers have pledged to:
- Standardize electronic prior authorization submissions using Fast Healthcare Interoperability Resources (FHIR®)-based application programming interfaces.
- Reduce the volume of medical services subject to prior authorization by January 1, 2026.
- Honor existing authorizations during insurance transitions to ensure continuity of care.
- Enhance transparency and communication around authorization decisions and appeals.
- Expand real-time responses to minimize delays in care with real-time approvals for most requests by 2027.
- Ensure medical professionals review all clinical denials.
