L.A. Care Health Plan has cut 24% of its prior authorization requirements in what the insurance company characterized as an effort to lighten administrative burdens for providers, reduce discharge times and avoid care delays.
Some specialty care visits, laboratory tests, medical equipment and catheter supplies will no longer require prior authorization, the insurer said in a news release Wednesday. The company has axed roughly 14,000 billing codes from its list of those requiring prior authorization, CEO John Baackes said in an interview.
Related article: Why insurers are scaling back prior authorizations
L.A. Care offers four lines of health coverage plans to more than 2.5 million members, including Medicaid beneficiaries and those dually eligible for Medicare and Medicaid. The company has eliminated the requirements for all of its coverage lines.
Certain services, including inpatient care, clinical trials and transplant surgery, will still require prior authorization for L.A. Care members.
The company will continue weighing whether more cuts are necessary and whether some requirements should be reinstated, Baackes said.
Several insurance companies have recently made moves to dial back services that require prior authorization. Blue Cross Blue Shield of Michigan announced in September 2023 it would cut prior authorization requirements by 20% for Medicare and commercial enrollees. The month prior, Cigna said it would lift the requirements for more than 600 procedures in its commercial plans, representing 25% of requirements for commercial enrollees.
Baackes said he plans to retire from his position in early January. L.A. Care is in the process of appointing his successor.
