Humana is ramping up efforts to ease prior authorization (PA) requirements across its plans, aiming to reduce physician burden and speed up patient access to care by early 2026.

The insurer said it will cut roughly one-third of its prior authorization requirements for outpatient services, starting with removing the need for approvals on certain diagnostic procedures including colonoscopies, transthoracic echocardiograms, and selected CT and MR scans.

By January 1, 2026, Humana also plans to deliver a decision within one business day for at least 95% of complete electronic PA requests. The company currently meets that time frame for more than 85% of outpatient services.
“Today’s healthcare system is too complex, frustrating, and difficult to navigate, and we must do better,” said Jim Rechtin, president and CEO of Humana. “We are committed to reducing prior authorization requirements and making this process faster and more seamless to better support patients, caregivers, physicians, and healthcare organizations.”

In addition to trimming PA requirements and improving response times, Humana will introduce a “gold card” program in 2026. The program will waive prior authorization for providers who demonstrate a consistent track record of submitting medically appropriate requests and achieving favorable outcomes for Humana members.

The insurer also plans to publicly report metrics on its PA processes, including approval and denial rates, appeals, and turnaround times, aligning with federal transparency efforts.

Humana is continuing to invest in interoperability, with efforts focused on enhancing electronic health record integration and encouraging use of electronic prior authorization systems over manual methods like fax or phone.

The company reiterated its support for the Improving Seniors’ Timely Access to Care Act, a bipartisan bill in Congress aimed at further standardizing and digitizing the PA process for Medicare Advantage plans.

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