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We appreciate AHIP and the leading health plans for launching this bold, voluntary commitment to streamline, simplify, and reduce prior authorization — a process that remains a vital safeguard to ensure care is safe, evidence-based, and affordable. These new actions build on existing efforts to modernize outdated manual workflows and connect patients more quickly to the care they need, while minimizing administrative burdens on providers and payers alike. AHIP’s announcement outlines the industry’s shared vision for a more efficient future.
The initiative sets out six clear actions: standardizing electronic prior authorization using FHIR® APIs, reducing the scope of claims subject to prior authorization, ensuring continuity of care when patients change plans, expanding real-time responses, improving communication and transparency, and reaffirming medical reviews of non-approved requests. Mike Tuffin, AHIP President and CEO, emphasized that this collaboration aims to modernize the system and deliver a more seamless experience for patients and providers alike — reducing delays and freeing up clinicians to focus on care. Mehmet Oz, M.D., Administrator of the Centers for Medicare & Medicaid Services (CMS), described the pledge as “an opportunity for the industry to show itself,” noting its voluntary nature and broad reach. HHS Secretary Robert F. Kennedy Jr. also met with health plan leaders to discuss these commitments, underscoring the importance of aligning federal and private efforts to reform prior authorization.
At basys.ai, we believe trust, fairness, and transparency are fundamental to any AI used in healthcare — a point we shared in a STAT News article on confronting racial bias in clinical algorithms. That experience shaped how we build technology: always questioning our data, our models, and our impact on real people’s care. With this industry-wide intent now clear, we’re focused on helping plans turn that intent into fair, timely, and evidence-based decisions — through tools that automate approvals responsibly and reduce the bias and burden that too often hold patients back.
In a TEDx talk by our CEO Amber Nigam, he discussed the importance of aligning incentives across stakeholders to build a smarter, more equitable healthcare system. This industry pledge to improve prior authorization is a concrete step toward that alignment — showing how payers, providers, technology partners, and patients can work together to remove friction from care delivery and create a system that works better for everyone.
While this announcement marks real momentum, the true test will be turning these commitments into daily impact for patients and the clinicians who care for them. At basys.ai, we stand ready to support health plans and the entire healthcare ecosystem as we navigate this journey together — simplifying the complex, unlocking innovation, and helping make healthcare smarter, faster, and fairer for all.
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