About three -quarters of the country’s health insurance providers signed a series of commitments this week to try to improve patient care by reducing bureaucratic obstacles caused by the previous authorization requirements of insurance companies.
The director of the Medicare and Medicaid Services centers, Dr. Mehmet Oz, along with the Secretary of Health and Human Services, Robert F. Kennedy Jr., announced the new voluntary promise of a picture of insurance providers, which cover approximately 75% of the population during a press conference on Monday.
New commitments aim to accelerate and reduce previous authorization processes used by insurers, a process that has been reduced in the long run to delay patient care and other bureaucratic obstacles that adversely affect patients.
“Promise is not a mandate. It is not a bill, a rule. This is not legislated. This is an opportunity for the industry to show,” said Oz on Monday. “But because of the fact that three quarters of the country’s patients are already covered by participants in this promise, it is a good start and the answer has been overwhelming.”
Prior authorization is a process that requires suppliers to obtain the approval of a patient’s insurance provider before this supplier can offer certain treatments or services.
Essentially, the process aims for patients to have the right solution for a particular problem.
However, according to Oz, the process has led doctors to be forced to spend huge amounts of man’s power to meet the pre -authorization requirements of insurers.
During a Monday press conference, on average, doctors have to spend 12 hours a week, dealing with these requirements, which see about 40 of the week.
“It frustrates doctors. Sometimes it translates into a significantly delayed care. Erodine public confidence in the healthcare system. It is something we cannot tolerate,” said Oz.
Some of the country’s largest insurance providers have been adopted by the promise, such as United Healthcare, CIGNA, Human, Blue Cross & Blue Shield, Aetna and many others.
While industry -led commitments are aimed at improving patients’ care, it may also be consumed in their benefits if patients are starting to look for more often.
The commitments of the insurers of insurers this week include active measures to implement a standardized process common for the prior electronic authorization by developing standardized submission requirements to support faster change time.
The goal is for the new frame to be operational on January 1, 2027.
Another part of the promise includes a commitment to individual insurance plans to implement certain reductions in using the previous medical authorization on January 1, 2026.
On this date, if the patients change the insurance suppliers during the treatment, their new plan must honor their existing approvals of prior authorization for 90 days while the patient’s transitions.
Transparency is also a key part of the new commitments of insurance providers.
Health plans related to commitments will commit to providing clear and easy -to -understand explanations for prior authorization determinations, including guidance for appeals.
The commitment also states that by 2027, 80% of the electronic approves of prior authorization of companies will be answered in real time.
Oz, during a Monday press conference, compared the industry’s promise to the Bible, saying, “The Meek will inherit the earth.”
“I have always grown up thinking that” meek “meant weak, but this is not what it means.
“This is what these insurance and hospital systems have done,” he continued. “They have agreed to step on their swords for a time handled for a while, to find a better solution to a problem that plagues us all.”
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