Humana implements measures to expedite approvals

Humana (HUM) announced accelerated efforts to approve care requests as quickly as possible and reduce the administrative burden for physicians associated with prior authorization. These actions will aim to reduce the number of prior authorization requirements and make the process faster and more seamless, while preserving the system of checks and balances that protects patient safety. The announcement builds upon the recent series of commitments to streamline, simplify, and reduce prior authorizations made by health plans, including Humana, that were announced by AHIP and the Blue Cross Blue Shield Association. Humana is working to reduce the red tape on prior authorization in several ways: reducing prior authorization requirements: by January 1, 2026, Humana will eliminate approximately one third of prior authorizations for outpatient services. Humana will remove the authorization requirement for diagnostic services across colonoscopies and transthoracic echocardiograms and select CT scans and MRIs. By January 1, 2026, Humana will provide a decision within one business day on at least 95% of all complete electronic prior authorization requests. Currently, Humana provides 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. In addition, the company is committing to greater transparency on prior authorization. In 2026, Humana will report publicly its prior authorization metrics. Humana is working to expedite implementation of the new federal transparency requirements.