Healey axes insurance sign-offs for some medical care, citing delays for patients

Massachusetts residents who need cancer screenings, diabetes medications and other essential medical treatments will soon face shorter waits for care, Gov. Maura Healey said Thursday.

State health officials are updating regulations to eliminate the advance approvals that insurance companies often require for common tests and treatments. These are known as prior authorizations — when doctors must obtain a sign-off before their patient can receive care.

Administration officials said the changes would eliminate thousands of these authorizations every year, along with the paperwork and delays they often entail.

“When you're sick, it is so important that you're able to get that care as quickly as possible,” Healey told healthcare workers and members of the media Thursday at Dana-Farber Cancer Institute. “That you're able to get in to see the doctor, to see the specialist, to get that screening, to get that blood work, to get that medication.”

Dr. Craig Bunnell, Dana-Farber’s chief medical officer, said a reduction in insurance approvals will help cancer patients who need time-sensitive care.

“Ever minute matters,” Bunnell said. “For our patients, a delay of even a couple days can affect treatment, outcomes and peace of mind.”

The new regulations prohibit prior authorizations for emergency and urgent care, primary care and maternity care. They also remove the requirements that patients with certain chronic conditions obtain insurance approval before accessing imaging tests, physical therapy and medications.

Insurers would have to respond to urgent patient requests within 24 hours, according to the new rules. And patients with chronic diseases would no longer need annual approvals to continue treatments they’ve already begun.

Healey said the changes would help control costs but did not detail the expected savings.

Healthcare providers and patient advocates have long argued that prior authorizations increase costs and delay important medical care. Insurance companies, though, defend the approval process as a critical strategy to control medical spending and reduce unnecessary care.

Lora Pellegrini, president of the Massachusetts Association of Health Plans, an industry group, said insurers have streamlined the authorization process. But she said administrative changes alone will not make healthcare more affordable.

“Those efforts must be paired with meaningful action to address the underlying drivers of cost growth — including rising hospital prices, outpatient facility costs, and prescription drug spending,” she said in a statement.