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.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.