The Biden administration on Wednesday finalized a rule aimed at streamlining health plans’ use of prior authorization, fulfilling a priority of physician groups and many members of Congress.
The rule would require Medicare Advantage organizations, Medicaid and other government-sponsored health programs to respond to prior authorization requests faster and include specific reasons for denying requests.
“When a doctor says a patient needs a procedure, it is essential that it happens in a timely manner,” Health and Human Services Secretary Xavier Becerra said in a statement. “Too many Americans are left in limbo, waiting for approval from their insurance company.”
