Automating Prior‑Authorization Tradeoffs

Prior authorization currently constrains the highest‑cost, preplanned treatments and has demonstrably reduced waste and some harms (e.g., opioid dosing). Emerging automation and AI can speed approvals and reduce clinician burden, but they also institutionalize adjudication rules at scale and will inflate controversy as industry introduces many costly marginal therapies with limited benefit. — How regulators and policymakers decide to automate, audit, and limit prior authorization will determine whether cost control preserves access and clinical judgment or becomes a technocratic bottleneck that reshapes which treatments patients can actually receive.