STAT+: Biden changes will force health insurers to speed up and get more specific if they want to deny care
The Biden administration wants to force insurance companies to give specific reasons for denying coverage, and to speed up denials.
The Biden administration moved Wednesday to force insurance companies to give specific reasons for denying coverage, and to speed up the pre-approval process in general.
The new rule applies to health insurance companies that offer Medicare, Medicaid, Children’s Health Insurance Program, and Obamacare plans. It concerns so-called prior authorization requests, and will require insurers to return urgent requests within 72 hours and non-urgent requests within seven days.
The changes are a win for patients seeking care, but also for health care providers like hospitals and physicians. Executives from California-based Sutter Health, Massachusetts General Brigham, and others repeatedly cited the rise in insurer denials since the pandemic at last week’s J.P. Morgan Healthcare conference.
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