What’s going on with prior authorization?

Here are four updates on prior authorization for ASC leaders and physicians to know, as reported by Becker’s so far in 2025:

  1. Rep. Mark Green, MD, a Republican from Tennessee, reintroduced a bill to Congress that would reform prior authorization requirements.
  2. Prior authorization rates are increasing at ASCs, according to HST Pathways’ latest “State of the Industry Report.” In 2024, 46% of cases completed preauthorizations, up from 42% in 2023.
  3. The implementation of AI has become widespread in healthcare, but physicians are concerned that unregulated AI use is increasing prior authorization denials. More than 60% of physicians said they feared that payers’ use of unregulated AI was creating more prior authorization denials, according to a survey from the American Medical Association.
  4. Rep. Jeff Van Drew introduced a bill that would ban prior authorization across health plans.

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Cameron Cortigiano