AHIP Shares Update on Plan Progress to Simplify Prior Authorization

AHIP shared progress on the voluntary, multi-year commitments made by AHIP, BCBSA, and leading health plans (including Cigna Healthcare) to streamline and simplify prior authorization. Health plans serving nearly 270 million Americans are participating in this initiative. The 2026 commitments took effect on Jan. 1 and include: reducing the scope of claims subject to prior authorization; ensuring continuity of care when patients change plans; enhancing communication and transparency on determinations; and ensuring medical review of non-approved requests (a standard already in place).

Health plans are now working on two interrelated and transformational commitments for 2027 with multi-year timelines: expanding real-time responses and standardizing electronic prior authorization. These two commitments are a substantial technical and operational undertaking that will ultimately enable most prior authorizations to be routinely approved at the point-of-care, while giving providers a faster and more consistent experience.

Health plans welcome continued collaboration with policymakers and stakeholders as progress continues.