While prior authorization is designed to build checks and balances into the healthcare system and ensure that patients receive safe, high-quality care, we know it adds an additional step in the process for patients and providers that’s too often highly complex and frustrating.  We support efforts to reform, simplify, and reduce prior authorizations.

Bipartisan Reform to Improve Patient Access to Care

Humana strongly supports the bipartisan Improving Seniors’ Timely Access to Care Act and has called on both the House of Representatives and the Senate to pass the legislation. The bill would accelerate the adoption of electronic prior authorization, helping to modernize the process, increase transparency, and expedite approvals. By replacing manual workflows with digital exchanges, electronic prior authorization can reduce administrative burden while enabling faster decisions and a more seamless experience for patients and providers.

How Humana is Working to Help

Humana is committed to simplifying the customer experience and making healthcare easier to navigate for our members. In 2025, we announced new actions to reduce the number of prior authorization requirements and make the process faster and more seamless for patients and providers, while preserving important safeguards that protect patient safety. Here’s how:

• Reducing prior authorization requirements. Across 2024 and 2025, Humana removed prior authorization requirements for more than 340 codes, accounting for approximately one-third of prior authorizations for 2025 outpatient diagnostic services. These changes span services such as colonoscopies, transthoracic echocardiograms, and select CT scans and MRIs.

• Faster, more streamlined process for approvals. Starting January 1, 2026, Humana is providing a decision within one business day on at least 95% of all complete electronic prior authorization requests, expediting care decisions and helping beneficiaries get the right care in a timely manner. Humana had previously provided a decision within one business day on more than 85% of outpatient procedures.
• Creating a national gold card program for physicians. In 2026, Humana will launch a new gold card program that waives prior authorization requirements for certain items and services for providers who have a proven record of submitting coverage requests that meet medical criteria and delivering high-quality health care with consistent outcomes for Humana members.

• Improving transparency and accountability. Starting in 2026, Humana publicly reported its prior authorization metrics, including approval and denial rates, approvals after appeal, and the average time between submission and decision.

Supporting Industry-Wide Improvement

Building on these efforts, Humana continues to collaborate with other health plans through AHIP and the Blue Cross Blue Shield Association to support meaningful, system-wide change. By April 2026, important new progress was announced to:

• Eliminate 11% of prior authorizations across a range of services—representing 6.5 million fewer prior authorization requirements for patients.
• Standardize the process to electronically submit required clinical information, reducing paperwork for providers and speeding patient access to care.
• Ensure continuity of care when patients change plans by honoring existing prior authorizations for benefit-equivalent in-network services as part of a 90-day transition period.

Prior authorizations should be fast, simple and invisible to the patient. That is the goal we are working toward. Through meaningful reductions, greater transparency, and collaboration with providers, policymakers, and industry partners, Humana is focused on ensuring prior authorization works better for everyone—while ensuring that members receive the right, high-quality care at the right time.

Learn more about our policy efforts on the Humana health policy website.