Medicare AdvantagePrior AuthMedium impact
Turnaround time for authorizations changing
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Effective January 1, 2026, BCBSRI is reducing the turnaround time for routine prior authorizations from 14 calendar days to 7 calendar days for both Medicare and Medicaid cases. This change follows new CMS requirements and will be implemented by BCBSRI and their vendors.
Action Required
By January 1, 2026: Prior authorization team must update workflow expectations to receive BCBSRI authorization decisions within 7 calendar days instead of 14 days for routine cases. Update scheduling protocols to account for shorter turnaround times. Monitor authorization status more frequently to avoid delays in patient care.