By Leah Douglas and Ahmed Aboulenein
WASHINGTON (Reuters) -U.S. health secretary Robert F. Kennedy Jr. met with major health insurers on Monday, extracting pledges that they will take additional measures to simplify their requirements for prior approval on medicines and medical services.
Insurers including UnitedHealth Group’s UnitedHealthcare, CVS Health’s Aetna, Cigna Group, Humana, Blue Cross Blue Shield Association and Kaiser Permanente met with Kennedy and Centers for Medicare and Medicaid Services Administrator Mehmet Oz, the Department of Health and Human Services said in a statement.
The health insurers pledged six key reforms aimed at cutting red tape, accelerating care decisions, and enhancing transparency for patients and providers, HHS said in the statement.
Participation in the pledge is voluntary, Oz said in a news conference. Three-quarters of U.S. patients are covered by participants in the pledge, he said, adding that CMS will publish the full list of participating plans later this summer.
“There shouldn’t be paper, there shouldn’t be faxes, there shouldn’t be letters being sent. They should all be done digitally and automatically, and 90-day continuity should exist for authorizations when patients switch insurers, so you never fall through the cracks again,” Oz said.
“If the insurance industry cannot address the needs of pre-authorization by themselves, there are government opportunities to get involved,” Oz said.
The pledge includes health insurers working to develop standardized data and submission requirements for electronic prior authorization by January 1, 2027.
The companies also will work on reducing the scope of claims that require prior authorization by January 1, 2026, and ensure the authorizations are valid for a 90-day period if the patient changes insurance companies during the course of treatment.
The pledge was announced earlier on Monday by insurance industry trade group AHIP, which also attended the meeting.
“The healthcare system remains fragmented and burdened by outdated manual processes, resulting in frustration for patients and providers alike,” AHIP CEO Mike Tuffin said.
The killing of the head of UnitedHealth’s insurance unit last year ignited significant social media backlash from Americans struggling to receive and pay for medical care.
(Reporting by Leah Douglas and Ahmed Aboulenein; Additional reporting by Ryan Jones; Editing by Mark Porter and Bill Berkrot)
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