Is Insurers’ Prior Authorization Pledge a PR Move or True Reform?

Jul 03
Jul 03, 2025

Amid mounting consumer, provider and lawmaker frustrations over insurers’ reliance on prior authorizations to control medical costs, a group of payers including major publicly traded companies recently unveiled a pledge to revamp their own PA practices before the federal government takes action. But industry experts say much of what they’re promising is already being mandated in federally sponsored health care programs, and it remains to be seen whether they’ll be ready to adopt these changes on the commercial side, let alone in Medicare or Medicaid.
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Lauren Flynn Kelly

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.