Centene Launches Gold Card Program to Waive Prior Authorizations for Top Providers

Centene announced on Tuesday that it will launch a National Performance‑Based Gold Card Program next month as the industry works to reform prior‑authorization processes.

The program exempts more than 160,000 high‑performing providers from routine prior‑authorization requirements for specific medical services, procedures or prescriptions, based on their approval history, documentation quality and compliance with plans' medical policies.

Qualifying providers must submit a pre‑notification before rendering services, but then can provide care without waiting for insurer approval; the program will initially cover outpatient services and expand over time.

Gold card programs are praised for removing administrative barriers and speeding patient care, though insurers have historically been wary of over‑utilization; several states have passed or are considering legislation to mandate similar programs, and the Trump administration secured voluntary pledges to cut prior authorizations with an 11% reduction so far.

Other insurers have followed suit—Humana launched a similar program this year and UnitedHealthcare expanded its fast‑pass program, increasing eligible provider groups by 80% in two years—yet providers and patients still criticize the persistence of prior authorizations, and many groups continue to push insurers to adopt gold card programs.