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Aetna Slashes Cancer Treatment Pre-approvals
17 Sep
Summary
- Aetna to reduce cancer treatment preapprovals to one early process.
- New bundled approval process to launch in first half of 2027.
- 74% of providers cite administrative burden as a top challenge.
CVS Health's Aetna health insurance unit is set to simplify preapproval processes for cancer patients. Beginning in the first half of 2027, Aetna will require only one medical prior authorization early in the treatment journey for its private and Medicare Advantage plans. This change, already initiated for Medicaid members in eight states as of September 1, aims to reduce the administrative burden on healthcare providers.
Currently, providers submit an average of four prior authorizations per Aetna cancer member. The new bundled approach will allow for a single approval based on documentation of cancer treatment, rather than separate authorizations for chemotherapy, radiation, imaging, and some immunotherapies. Aetna plans to potentially extend this streamlined model to other conditions like musculoskeletal issues in the future.
This initiative aligns with broader industry efforts to curb administrative complexities. A survey indicated that 74% of providers find administrative burden a significant challenge, with prior authorizations being a major contributor. Competitors like UnitedHealthcare and Humana have also announced plans to reduce their prior authorization requirements.
