is semaglutide being banned in the us American Medical Association calls for insurers to cover weight loss drugs FDA warns consumers not to

doi: 10.3389/fnut.2021.756243

Already in effect (January 1, 2026): Standard PA decisions within 7 calendar days (down from 14) Urgent PA decisions within 72 hours Specific denial reasons required on every denial (not just not medically necessary) Applies to Medicare Advantage, Medicaid managed care, CHIP, and ACA Marketplace plans Coming March 31, 2026: Payers must publicly report PA metrics for calendar year 2025: approval/denial rates, average decision times, and appeals outcomes Providers will be able to compare payer performance for the first time Coming January 1, 2027: FHIR-based Prior Authorization APIs required providers check PA requirements, submit requests, and receive decisions electronically through their EHR Expected to reduce average PA processing time from days to minutes for standard requests Medicare WISeR Model (live in AZ and WA): The Wasteful and Inappropriate Services Reduction pilot launched January 2026 in six states including Arizona and Washington

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Lilly's selective amylin agonist, eloralintide, demonstrated meaningful weight loss and favorable tolerability in a Phase 2 study of adults with obesity or overweight