Overview

• Dozens of insurers including UnitedHealthcare, Aetna, Cigna, Humana, Elevance Health and Blue Cross Blue Shield pledged reforms covering 257 million Americans in commercial, Medicare Advantage and Medicaid managed care plans.
• The framework requires plans to reduce the types of services subject to prior authorization by January 1, 2026 to address delays and administrative burdens.
• Insurers agreed to standardize electronic prior authorization submissions by January 1, 2027 with a goal of answering at least 80% of complete requests in real time.
• The agreement ensures continuity of care by honoring existing authorizations for 90 days after patients switch carriers and commits insurers to clearer denials explanations and appeal support.
• HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz led the roundtable where the voluntary steps were announced, though experts warn the industry may need legislation to guarantee follow-through.