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 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.
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