AHIP and BCBSA provide progress update on prior authorization commitments

April 15, 2026

EGWP marketplace medicaid Medicare

On April 7, The Cigna Group joined other health plans in announcing an update on the industry’s progress implementing the voluntary prior authorization commitments made in partnership with the Department of Health and Human Services and CMS last year.

Since June 2025, participating health plans have eliminated 11% of prior authorizations across a range of medical services, representing 6.5 million fewer prior authorizations for patients. This reduction is helping to ease administrative burdens and speed up access to evidence-based care. Health plans also affirmed improvements that make it easier for members who switch insurance to maintain their prior authorization approvals, known as continuity of care, and enhanced communications on prior authorization determinations.

AHIP and BCBSA are jointly briefing key policymakers and stakeholders on progress across the core commitment areas. Additional components of the commitments take effect in 2027, and taken together, these collective improvements will lead to a faster, more standardized and simplified experience, benefiting patients and providers.

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June 19, 2026

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legislation

Bicameral Patients before Monopolies Act reintroduced

On May 13, bipartisan lawmakers in the House and Senate reintroduced the Patients Before Monopolies (PBM) Act (S.4509/H.R.8779), legislation that would prohibit common ownership of PBMs, insurers, and pharmacies. Sponsored by Sens. Warren (D-MA) and Josh Hawley (R-MO) alongside Reps. Diana Harshbarger (R-TN) and Jake Auchincloss (D-MA), the bill would require impacted organizations to divest […]
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June 10, 2026

EGWP marketplace medicaid Medicare

legislation

CMS announces ePA acceleration initiative, democrats seek to repeal WISeR Model

The Centers for Medicare & Medicaid Services (CMS) is advancing its electronic prior authorization (ePA) efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. To date, 29 health care organizations – including health systems, electronic health record developers, physician practices, networks, and digital health […]
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June 10, 2026

EGWP marketplace medicaid Medicare

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