Prior authorization

Find prior authorization resources to support reform, improve practice efficiency and provide data to highlight the need for change.

Person passing paperwork to someone over a laptop

Prior authorization is a health plan cost-control process that requires providers to qualify for payment by obtaining approval before performing a service. It is overused, costly, inefficient, opaque and responsible for patient care delays.

We're taking a number of steps to reform prior authorization this year:

  • Working with payers to reduce the overall volume of prior authorizations
  • Increasing transparency on requirements
  • Promoting automation
  • Ensuring timely care for patients