What Is the American Health Insurance “Prior Authorization” Business That Profits by Denying Coverage for Tests and Treatments?

A ProPublica and The Capitol Forum investigation says EviCore, owned by Cigna, handles prior authorization reviews for major insurers.

The report says AI-assisted screening and cost-cutting incentives may lead to more denials for tests and treatments, including MRIs and cancer care.

The findings highlight how prior authorization and outside review vendors can shape access to care and raise patient costs in the U.S.,