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.