New Rules Seek to Reform Prior Authorization Process for Millions, But Critics Say More Change Needed
• New US rules aim to speed up private health insurers' approval process and increase transparency around denials.
• Rules will apply to plans covering 105M people, but exclude 158M with employer plans.
• Insurers argue prior authorization reduces unnecessary care, but patients say it delays and discourages needed care.
• Woman with rare vascular condition had to wage public pressure campaign to get insurer to cover surgery.
• Rules seen as a step in the right direction but not going far enough to tackle the widespread problems with prior authorization.