Humana to publicly report prior authorization metrics in 2026

Humana to publicly report prior authorization metrics in 2026

Humana Inc., a leading health and well-being company, has announced plans to publicly report its prior authorization metrics by the end of 2026. This move comes as part of the company's ongoing efforts to streamline and simplify the prior authorization process, aiming to enhance the patient experience and reduce administrative burdens for healthcare providers.

The company aims to eliminate approximately one-third of prior authorization requirements for outpatient services by January 1, 2026. This includes removing authorization requirements for diagnostic services across colonoscopies, transthoracic echocardiograms, and select CT scans and MRIs. Additionally, Humana plans to provide a decision within one business day on at least 95% of all complete electronic prior authorization requests by the same date, further expediting care decisions and ensuring timely access to care.

Humana is also launching a national gold card program for physicians in 2026. This program will waive prior authorization requirements for certain items and services for providers who have a proven record of submitting coverage requests that meet medical criteria and delivering high-quality healthcare with consistent outcomes for Humana members.

Moreover, Humana will publicly report its prior authorization metrics in 2026. These metrics will include prior authorization requests approved, denied, and approved after appeal, as well as the average time between submission and decision. The company is working to expedite the implementation of new federal transparency requirements to ensure accurate and timely reporting.

Humana's efforts to advance interoperability and reduce administrative burdens are also highlighted in this announcement. By enhancing electronic health record integration and promoting the adoption of electronic prior authorization requests, Humana aims to streamline the prior authorization process and improve the overall healthcare experience for patients and providers.

In addition to these internal commitments, Humana has long supported bipartisan legislation, such as the Improving Seniors’ Timely Access to Care Act, which aims to further modernize the prior authorization process and expedite the adoption of electronic prior authorization (ePA).

Humana Inc. (NYSE: HUM) is committed to putting health first for its teammates, customers, and company. Through its insurance services and CenterWell healthcare services, Humana strives to make it easier for millions of people to achieve their best health.

[1] https://www.businesswire.com/news/home/20250722551810/en/Humana-Accelerates-Efforts-to-Eliminate-Prior-Authorization-Requirements-to-Ensure-a-Faster-More-Seamless-Process
[2] https://www.stocktitan.net/news/HUM/humana-accelerates-efforts-to-eliminate-prior-authorization-ge3hpwdd46px.html