EmblemHealth, a US-based non-profit health insurer, has cut the number of medical procedures for which members will require prior authorisation before receiving care, effective 1 January 2020, it was reported yesterday.

The change affects all of the company's health insurance plans, including Medicaid managed care, Medicare Advantage, coverage provided through employers, and Individual Market plans on the Exchange.

Karen Ignagni, president and CEO of EmblemHealth, said, 'EmblemHealth is transforming all of its operations. As part of that effort, we are reducing red tape and simplifying administrative processes for our clinical partners. This has led us to cut prior authorisation requirements in half. Through careful analysis of our data, we identified services that almost always get approved. Not requiring prior authorisation of those services, such as surgical procedures where patients are going to the hospital (ie some cardiac and vascular procedures, gallbladder removal and treatment of glaucoma), will ensure that our members are receiving the care they need quickly and efficiently. Looking forward, we will continue to review our data with the goal of finding additional ways to reduce red tape and simplify administrative procedures.'