Biden Cracks Down on Prior Authorization — But There Are Limits

The Biden administration announced a final rule changing how insurers in federal programs like Medicare Advantage use prior authorization, which has long prevented many patients from accessing doctor-recommended care. The rule will require some insurers to adopt an electronic process for prior authorization and respond to requests within specified time frames. However, it only applies to federal program insurers and does not cover insurance that many Americans get through their jobs. Patients and doctors have long struggled with the prior authorization process, which is often confusing, time-consuming, and leads to denials and delayed care. This rule is seen as a step in the right direction, but further changes and transparency are needed.

Source link