Humana (HUM) said Tuesday it will eliminate about one-third of prior authorization requirements for outpatient services by Jan. 1, 2026, including for colonoscopies, echocardiograms, CT scans, and MRIs.
At least 95% of complete electronic prior authorization requests will be decided within one business day by that date, the company said.
A national gold card program will launch in 2026 to waive prior authorizations for providers with a consistent record of high-quality care, Humana said.
The company also said it will begin publicly reporting prior authorization metrics, including approval and denial rates, appeal outcomes, and average decision times.
The company is enhancing EHR integration and expanding electronic tools to speed up authorizations and ease the administrative burden for providers, it added.
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