
06/24/2025
HHS Secretary Kennedy, CMS Administrator Oz Secure Industry Pledge to Fix Broken Prior Authorization System.
Key commitments include:
- Standardizing electronic prior authorization via FHIR APIs
- Reducing services that require prior auth by Jan 1, 2026
- Honoring existing authorizations during insurance transitions (90-day continuity)
- Enhancing transparency in decisions and appeals
- Expanding real-time approvals for most requests by 2027
- Requiring medical reviewers for all clinical denials
These changes aim to reduce delays, simplify workflows, and improve patient care. CMS will monitor progress and step in if needed.
Health insurers pledged six key reforms aimed at cutting red tape, accelerating care decisions, and enhancing transparency for patients and providers.