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A Meaningful Shift: Administration & Payers Unite to Reduce Prior Authorizations

A Meaningful Shift: Administration & Payers Unite to Reduce Prior Authorizations

Jul 8, 2025

By Alix Goss – On June 23, 2025, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz, announced a significant agreement with major payers to reduce the volume and burden of prior authorizations across commercial, Medicare Advantage, Medicaid, and Marketplace plans.

Physicians Concerned AI Increases Prior Authorization Denials

Physicians Concerned AI Increases Prior Authorization Denials

Mar 10, 2025

Many physicians fear the health insurance industry’s use of unregulated artificial intelligence (AI) automation and predictive technologies will increasingly override good medical judgment and systematically deny patients coverage for necessary medical care.

Legislative Action Needed when Insurers won’t Pay for Preauthorized Care

Legislative Action Needed when Insurers won’t Pay for Preauthorized Care

Nov 25, 2024

Continued physician frustration with excessive and disruptive prior authorization controls required by health insurers resulted in calls for legislative and injunctive action by the American Medical Association to fight retrospective denial of payment for care that has been pre-certified by an insurer.

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