Unpacking health insurers’ prior authorization announcement

Health insurers recently announced steps to improve the prior authorization process, a move that was praised by US Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz. This initiative responds to longstanding complaints from patients and providers about the complexity and burden of prior authorization, which often leads to denied coverage for necessary care. While CMS and HHS have already implemented regulations to address these issues, the question remains whether the new industry commitments add anything beyond what is already required.

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