Prior authorization entered 2026 with new federal turnaround requirements. Beginning Jan. 1, Medicare Advantage organizations and several Medicaid and CHIP payers generally must send decisions for non-drug medical items and services within 72 hours for expedited requests and seven calendar days for standard requests. Payers also must give providers a specific reason when denying an authorization request.
Those changes were intended to shorten waits and give practices clearer information when a request is denied. But the question for medical groups is simpler: Has prior authorization actually gotten faster?
For most practices, the answer is “no.” In a Sept. 1, 2026, MGMA Stat poll, 44% of medical group leaders said payer prior authorization turnaround became slower in 2026 compared with 2025. Another 40% said turnaround is about the same, while 7% reported faster turnaround, and 9% were unsure. The poll had 178 applicable responses.
Follow-up responses from this week’s practice leaders showed that a few key commercial payers continue to be major sources of delay. Among respondents reporting slower turnaround, the most common bottlenecks involved status checks, peer-to-peer reviews and increasingly burdensome documentation requirements. Practices reporting faster turnaround most often pointed to payer reductions in authorization requirements, broader use of electronic submission tools and internal workflow improvements that streamlined the authorization process.
The share reporting slower turnaround is particularly notable because a shorter regulatory decision deadline does not necessarily mean the entire authorization process is taking less time for the practice.
Where the wait accumulates
Prior authorization burden was already heading in the wrong direction entering this poll. MGMA Government Affairs' 2026 Regulatory Burden Report found that 90% of practices said PA burden increased during the previous 12 months. Respondents ranked Medicare Advantage as the most burdensome payer type for obtaining authorization, followed by commercial plans, Medicaid and Traditional Medicare.
This week’s follow-up responses show where slower turnaround is concentrated — and, just as importantly, where the delays occur.
For practices, the authorization process can extend well beyond the payer’s formal decision period. Staff first may need to determine whether PA is required, identify the right submission channel and assemble supporting documentation. After submission, staff may face requests for more information, status checks, peer-to-peer reviews, denials and appeals.
Recent MGMA Stat polling shows how much staff work remains tied up in those steps. In March, 45% of practice leaders said eligibility and prior authorization were their staffs’ most time-consuming phone tasks. Respondents specifically pointed to submitting requests, tracking status and handling denials and appeals as sources of workload.
Another March MGMA Stat poll found 61% of practices had staff accessing seven or more payer portals each week. Eligibility and prior authorization were among the main reasons, with respondents describing repeated logins, data entry, payer-specific requirements and tasks that could not be completed through their EHR or other systems.
That makes the location of the delay important. A practice waiting days for a payer decision faces a different problem from one whose staff lose hours getting a complete request submitted or repeatedly checking its status.
Two kinds of faster turnaround
Follow-up answers from practices reporting improvement point to two distinct sources of faster turnaround: changes made by payers — such as reduced PA requirements, electronic submission or gold-carding — and changes practices made themselves, including adding staff, redesigning workflows or adopting new PA technology.
If a practice reduced turnaround by adding another authorization specialist or increasing manual follow-up, patients may receive answers sooner while the cost and administrative burden on the practice still increase. Faster electronic submission, fewer authorization requirements or more responsive payer processes would represent a more meaningful reduction in administrative burden.
Our 2025 review of the prior authorization landscape anticipated faster decisions and clearer denials across 2026 and 2027, along with a larger shift toward electronic exchange. The next major federal deadline comes Jan. 1, 2027, when affected payers must implement Prior Authorization APIs designed to enable more direct electronic exchange of PA information.
Tracking more than the final decision
Practices that answered “unsure” have another question to consider: Do you have enough information to know which payers are actually getting better or worse?
At minimum, practices should consider tracking payer and plan, submission and decision dates, whether the request was standard or expedited, requests for additional information, status checks, peer-to-peer reviews, denials, appeals, and the final resolution date.
CMS now requires impacted payers to publicly report aggregate PA metrics annually, including approval and denial rates, approvals after appeal and average time between submission and decision. Practice-level tracking can add the detail leaders need to compare their actual experience across payers and identify whether delays occur before submission, during payer review or after the initial decision.
That baseline will become more valuable as electronic PA requirements expand. MGMA Government Affairs recently released a resource on the new payer API technical requirements and steps practices can take to prepare for 2027.
Technology may eliminate some portal logins, repeated data entry and manual handoffs. It will not automatically fix every PA delay. Practices that know where their authorizations stall today will be better equipped to tell whether payer changes are actually saving time tomorrow.
