06.24.2025 / Statement

New Prior Authorization Plans: Good First Step, But More Efforts Needed to Ease Patients’ Frustrations

WASHINGTON, D.C. – Anthony Wright, executive director of Families USA, issued the following statement in response to health insurer’s plans for voluntary prior authorization reforms.

“The insurer’s plan for recommended changes to prior authorization is a step in the right direction, but much more is needed to ensure that patients know they can get the care they need when they need it. We are glad that health plans are recognizing and responding to the real patient and provider frustration with the prior authorization process that too often delays and denies medically necessary care.

“We believe these and other consumer protection commitments should be in statute and not just voluntary. As we have argued since the debates on a Patients Bill of Rights legislation in the 1990s, we need strong consumer protections against unfair delays or denials, including an independent and speedy appeals process, because no one should be denied care or slapped with a huge medical bill for needed treatment that should have been covered.

“Standardizing criteria and streamlining the authorization process to provide real-time responses would be positive for patients, and we will continue to seek other improvements as well at the state and federal level. We ultimately seek a system that puts the burden of appeals on the system rather than the individual patient who is, by definition, already dealing with medical issues.

We look forward to working with AHIP and policymakers in Washington and the states to recommend reforms that will ensure people can get the care they need when they need it.”