Humana to reduce about one-third of prior authorization requirements
The company will remove the authorization requirement for diagnostic services across colonoscopies and transthoracic echocardiograms and select CT scans and MRIs by January 1, 2026.
Insurers have been facing increased scrutiny and backlash over the lengthy paperwork required to carry out specific services or treatment. While the companies have said it ensures people receive required care and helps to keep track of costs, patients have argued that the long process leads to care delays or denials.
"Today's healthcare system is too complex, frustrating, and difficult to navigate, and we must do better," said Humana CEO Jim Rechtin.
The killing of the head of UnitedHealth's (UNH.N), opens new tab insurance unit last year had ignited significant social media backlash from Americans struggling to receive and pay for medical care.
Several health insurers have since taken additional measures to simplify their requirements for prior approval on medicines and medical services.
America's Health Insurance Plans, the industry trade group, said last month health insurers would work to develop standardized data and submission requirements for electronic prior authorization by January 1, 2027.
UnitedHealth said in March it would ease requirements to get insurance authorization when renewing prescriptions on about 80 drugs, aiming to eliminate up to 25% of reauthorization requirements.
Humana said it would report publicly its prior authorization metrics, including requests approved, denied, and approved after appeal and average time between submission and decision, in 2026.
The company will also provide a decision within one business day on at least 95% of all complete electronic prior authorization requests, it said.
Currently, it provides a decision within one business day on more than 85% of outpatient procedures, in which patients do not require an overnight stay in the hospital.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Independent
10 minutes ago
- The Independent
Britain has no business laughing at Trump's EU trade deal
In a world where Donald Trump's tariffs and trade wars make everyone a loser, are there any winners from his latest deal, sealed by a handshake with the president of the European Commission, Ursula von der Leyen, in a ballroom at one of the president's Scottish golf courses, of all places? One very clear loser is von der Leyen herself. If body language is anything to go by, she looked like she'd been badly bullied by the Big Orange Man – and, truthfully, so she had. In her own clipped remarks, she admits that a reduction in tariffs to 15 per cent, while 'not to be underestimated', was 'the best we could get'. President Macron has declared the US-EU trade deal a 'dark day' for Europe – and you can understand why. A general tariff level of 15 per cent – better than the 20 per cent proposed by Trump on his infamous 'Liberation Day' in April, and even better than the 30 per cent he was threatening a couple of weeks ago – is still prohibitive. It is certainly way above the 2 to 3 per cent levels that most EU exporters used to face. A trade war has been avoided, but this looks like the kind of deal the Americans have forced on the likes of Vietnam or Indonesia. So it is something of a humiliation for the mighty European Union, a global trade superpower. The feeling in some parts of Europe must be that if von der Leyen had played hard ball like the Chinese, a more evenly balanced and more advantageous relationship could have been reached in the long run. We will never know the truth about that. For European pride and for many of its great industrial concerns, the deal is disappointing, and will be expensive – the Volkswagen group is just one to speak out. But for European consumers, it is surely good news. They will be able to enjoy cheaper imports from the United States; it is American customers who will have to pay more for their French wines and Italian sports cars. Could it be that the EU's trade deal – which Trump has, well, trumpeted as the 'biggest ever', and whose biggest 'win' is the removal of a threat to raise tariffs to 30 per cent later this week – is marginally worse than the one Starmer did with Trump in May? Britain's trade deal lowered tariffs of UK goods imported into the US to 10 per cent, and imposed a lesser, 25 per cent tariff on the UK steel industry, with room for further concessions, while the 50 per cent 'worldwide rate' will remain for the EU. For those now cheering this as a rare Brexit benefit, it is a hollow victory. For the concessions to Britain are so minor, they cannot hope to make up for the ground lost since Brexit – essentially, a GDP loss in excess of 5 per cent. And we're not out of the rough, by any stretch. As Keir Starmer meets the US president for further trade discussions at the Trump Turnberry golf course, he will be acutely conscious of his counterpart's unpredictability. Starmer has milked the modest concessions he managed to wangle, particularly on cars and food standards, but much remains vague and far from nailed-down. The greatest danger is the fuzzy UK commitment to improve the trading environment for the US pharma groups will eventually mean an enormous increase in the drugs bill for the National Health Service, which it can ill-afford. Trump also omitted virtually the whole of the service sector from his UK deal, where the British actually enjoy a surplus, which is great until he decides otherwise. There are no legally binding rules here. The world economy remains highly inter-dependent, and globalisation, while receding, cannot sensibly be ended, as even Elon Musk tries to argue. All barriers to trade harm the country that erects them both directly and, in their depressing effects on world growth, indirectly. Consumers are charged more, on a highly regressive basis, companies are forced to pay more for inputs, and be less cost-effective, and competition and dynamic structural change are deliberately impeded. Whatever the details of the individual deals counties are trying to strike with one another, tariffs make us all poorer in the long run.
Reuters
11 minutes ago
- Reuters
Argentina economic recovery to moderate in the run-up to October vote : Reuters poll
July 28 (Reuters) - Argentina's ongoing economic recovery will moderate to a normal pace in the run-up to October's mid-term legislative election, a Reuters poll showed. At the start of 2025, Latin America's No. 3 economy behind Brazil and Mexico picked up strongly following a two-year recession that capped more than a decade of poor performance. Consumption got a boost from a drastic fall in inflation thanks to President Javier Milei government's "chainsaw" drive that shored up fiscal results, while facing intense social criticism. But Argentines are cutting some spending and investment plans amid a slackening labor market, resurging currency worries and tighter credit conditions. Gross domestic product (GDP) is set to expand at a still-decent 3.4% rate in 2026 from an expected 5.0% this year, according to the median estimate of 28 analysts polled between July 21-25. Inflation is forecast to fall to 23% in 2026 from a projected 42% this year. In 2024, consumer prices shot up 237%, the worst since 1991 when Argentina was experiencing a similar economic shock. "Growth stagnated in recent months as a result of flattening real wages, increased uncertainty and the slowdown in credit from a restrictive monetary policy," said Federico Filippini, head of research at Adcap. "Next year's forecasts are heavily influenced by the upcoming election and the government's ability to advance its reform agenda." Economic activity missed analyst calls in May on yearly terms and virtually stalled against April's levels, the latest data from a leading indicator showed. Businesses are feeling the pinch of high interest rates from the adoption of a market-based money supply scheme in line with a $20 billion International Monetary Fund (IMF) program signed in April. The implementation of the new framework also impacted local assets shaken by foreign exchange tensions caused by a drying up of U.S. dollar inflows from agricultural exports. "Volatility will continue, but less than in recent weeks, with interest rates moving more freely and agricultural exports remaining low until year-end," said Fausto Spotorno, economist at Orlando Ferreres. An expected $2 billion IMF disbursement should contribute to calm market anxiety before October's vote by bolstering Argentina's depleted international reserves. Unable to tap global debt markets due to the country's steep risk premium, the government has received some additional relief through special bond sales as well as bank "repo" deals. However, surging imports from Milei's economic opening keep the central bank's balance sheet under pressure, despite an increase in energy and mining exports. To address the issue, many Peronists campaigning for the October election want to return to a policy mix of devaluation, protectionism and industrial promotion. Voters rejected this approach at the ballot box in 2023, when Milei's La Libertad Avanza party won a presidential election vowing to trim the size of the state. Now his LLA has an advantage in polls over the Peronists, whose internal rivalries flared up after their leader Cristina Fernandez de Kirchner was put under house arrest for corruption. Investors hope Milei will push the "libertarian" agenda aggressively if his party wins more seats in Congress, recreating Argentina's economic transformation of the 1990s. "We may see a re-discussion of reforms that were attempted during the current legislature but failed... for example, comprehensive labor and tax reforms, potentially also a pensions reform," Citi analysts wrote in a report. "The new Congress could also give impulse to privatizations of some state companies that may require only a simple majority – Banco Nacion, (water utility) AySA and Aerolineas Argentinas." (Other stories from the Reuters global economic poll)
Reuters
11 minutes ago
- Reuters
Is U.S. stock rally near 'Mag 7' turning point?
ORLANDO, Florida, July 28 (Reuters) - As investors brace for the busiest week of the U.S. earnings season, with four of the 'Magnificent Seven' tech giants reporting, debate is picking up again about these megacap firms' influence over U.S. equity indexes and whether we could be seeing the beginnings of true market broadening. By some measures, this small clutch of tech titans' profits, market cap, and valuations as a share of the wider market has never been bigger. Broader indices are at record highs, but strip out these firms and the picture is much less rosy. Indeed, since the beginning of 2023, the S&P 500 composite - the benchmark 'market cap' index increasingly dominated by the 'Mag 7' - has gained 67%, more than double the 'equal-weight' index's 32%. Only two years ago, the S&P 500 composite/equal-weight ratio was 0.66, meaning the composite index was worth around two-thirds of the equal weight index. That ratio is now 0.84, the highest since 2003. There's good reason for that. According to Larry Adam, chief investment officer at Raymond James, 12-month forward earnings estimates for the S&P 500 have outpaced estimates for the equal-weight index by 14%. And Tajinder Dhillon, senior research analyst at LSEG, notes that the 'Mag 7' last year accounted for 52% of overall earnings growth. Many investors and analysts consider it unhealthy to have the fate of the entire market dependent on so few companies. It may be fine when they're flying high, but not so much if one or two of them take a dive. Plus, it makes stock picking more difficult. If the market basically goes where the 'Mag 7' or Nvidia go, why should an investor bother buying anything else? That's a recipe for market inefficiencies. There have recently been nascent signs that the market may be broadening out beyond tech and AI-related names, largely thanks to positive news on the trade front. Last week, the equal-weight index eclipsed November's high to set a fresh record. Raymond James's CIO Adam notes that the equal-weight index outperformed the S&P 500 last week for the fourth week in the last 13. More of the same this week would mark its first monthly outperformance since March. Can it hit this mark? Around 160 of the S&P 500-listed firms report this week, including Meta and Microsoft on Wednesday and Amazon and Apple on Wednesday. It's not a stretch to say these four reports will move the market more than the rest combined. LSEG's Dhillon says the Mag 7's share of total earnings growth is expected to fall to 37% this year and 27% next year. The expected earnings growth spread between Mag 7 and the wider index in the second quarter - 16.4% vs. 7.7% - is the smallest since 2023, and will shrink more in Q3, he adds. [Why does he believe this will be the case?] Larry Adam at Raymond James, however, thinks the recent market broadening is a "short-term normalization" rather than a "material shift". He thinks the earnings strength of the tech-related sectors justifies the valuation premium on these stocks. Regardless, what we know for sure is that fears about the market's concentration and narrowness have been swirling for years and there has yet to be a reckoning. The equal-weight index's rise to new highs last week suggests the rising tide is lifting all boats, not just the billionaire's yachts. Essentially, the Mag 7 and large caps are outperforming, but if you peel back the onion, other sectors like financials and industrials are also doing well. And look around the world. Many indices outside the U.S. that aren't tech-heavy are approaching or printing new highs also, like Britain's FTSE 100 and Germany's DAX. "To see the largest names leading isn't a worrisome sign, especially as they are backing it up with very strong earnings," says Ryan Detrick, chief market strategist at Carson Group. "This isn't a weak breadth market, it is broad based and a very healthy rally." This week's earnings might go some way to determining whether this continues for a while yet. (The opinions expressed here are those of the author, a columnist for Reuters)
