Prior authorization is entering what may be its biggest regulatory overhaul in years, with federal agencies and insurers pushing toward faster decisions, electronic workflows, and greater transparency. But many physicians remain deeply skeptical that the changes will meaningfully reduce administrative burden or improve patient access to care.
The article highlights mounting frustration among clinicians: 95% of physicians surveyed by the AMA said prior authorization delays necessary care, 79% reported patients abandoning treatment because of authorization barriers, and 26% said the process had contributed to serious adverse events in their practices. At the same time, insurers and CMS are rolling out reforms that include mandated electronic prior authorization systems, shorter decision timelines, and real-time approval goals by 2027.