Cigna to do away with prior authorizations for 25% of medical procedures

by John R. Fischer, Senior Reporter | August 29, 2023
Cigna says that it will get rid of 25% of its prior authorizations.
Cigna is slashing away prior authorizations for 25% of its medical services, eliminating administrative bottlenecks, and making it easier for patients to get access to certain nonemergency procedures.

The company announced the news on August 24, saying it would eliminate more than 600 codes. It says that since 2020, it has removed prior authorizations for over 1,100 medical services.

Like other insurers, the company has faced growing pressure from physicians and patient groups to reduce prior authorizations, with critics saying that the process is restrictive and creates more paperwork, delaying timely care, according to Reuters.

Studies have also shown that prior authorizations for certain procedures are unnecessary, leading the government to crack down on the process more in recent years.

“With this update, prior authorization now applies to less than 4% of medical services for most Cigna Healthcare customers, and the company continues to streamline its use to optimize care delivery,” said the company in a statement.

Later this year, Cigna Healthcare will also remove prior authorizations for close to 500 additional codes for Medicare Advantage patients.

This follows a suit levied against the company last year by the Justice Department, which accused it of submitting “false and invalid patient diagnosis codes to artificially inflate the payments Cigna received for providing insurance coverage to its Medicare Advantage plan members.”

Earlier in 2023, UnitedHealth Group said it would reduce prior authorizations by 20% for some nonurgent surgeries and procedures. Those reductions will start in the third quarter and continue throughout the rest of the year for most commercial, Medicare Advantage, and Medicaid businesses, reported Reuters.

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