Humana has announced several steps it will take to ease prior authorization requirements.
The insurer said Tuesday that by the start of next year, it will have fully eliminated about a third of prior auth requirements for outpatient services. These include diagnostic services such as colonoscopies, echocardiograms and select CT and MRI scans.
In addition, the company said it will continue to streamline the approval process. By Jan. 1, 2026, 95% of prior auth requests submitted electronically will receive a response within one business day. At present, the insurer responds within a business day for 85% of outpatient services.
Humana also said it will create a national gold card program for physicians, a common ask from the provider community. Next year, the insurer will launch a program that waives prior auth requirements for certain services for providers who have "a proven record" of submitting requests that meet medical criteria.
“Today’s healthcare system is too complex, frustrating, and difficult to navigate, and we must do better,” Humana CEO Jim Rechtin said in the press release. “We are committed to reducing prior authorization requirements and making this process faster and more seamless to better support patients, caregivers, physicians, and healthcare organizations.”
In the announcement, the insurer also said it would be transparent around its prior auth activity. Humana said it would begin in 2026 to publish data around approvals, denials and appeals as well as the time it took to respond to a request.
Humana said these commitments build on the broader industry pledge issued earlier this year to address prior auth burdens. It was one of dozens of insurers large and small that signed on to the promise, which also included backing from two of the industry's largest lobbying organizations: AHIP and the Blue Cross Blue Shield Association.
The payers who signed onto the pledge said they would be able to demonstrate progress toward easing the prior auth process by Jan. 1.
Humana also said it is working to advance interoperability as well as to support better data exchange between payers and providers, and the efforts around prior auth fit into that broader goal. The company has maintained support for the Improving Seniors’ Timely Access to Care Act, a bipartisan bill that would further streamline prior auth and drive adoption of electronic methods.