- Oncology bundling to support all eligible Medicaid members for all cancer types
- Full roll-out across all Aetna businesses in 2027
Originally published on CVS Health Company Newsroom
WOONSOCKET, R.I., September 24, 2026 /3BL/ — Aetna®, a CVS Health® company (NYSE: CVS), is expanding prior authorization bundles across all cancer types for members in eligible1 Medicaid states as of September 1, with plans to expand across all lines of business in 2027. This expansion builds on the success of the initial roll-out, with almost 25% of eligible members receiving a bundled prior authorization, assuring their services have been approved in advance to accelerate their access to care.
On average, Aetna saw that providers were submitting four separate prior authorizations for each member in need of cancer treatments.2 By offering a single, secure prior authorization for a bundle of cancer treatments, Aetna is helping patients access care simply throughout their treatment journey. Prior authorization bundles combine medical oncology, including chemotherapy and immunotherapy where appropriate, and/or radiation oncology services with associated high-tech imaging needs, such as MRI or CT scans, into one request submitted through a single portal.
“A cancer diagnosis can be overwhelming for patients and families, and the care team should be focused on their patient, not paperwork,” said Katerina Guerraz, Aetna Chief Operating Officer and President of Medicaid. “By approving a broader set of treatments and related services upfront, we’re removing barriers that can delay care. Oncologists have the flexibility to make care decisions as treatment plans evolve, and individuals can focus on what matters most: their health, recovery, and time with their loved ones.”
Administrative burden remains a significant challenge for healthcare providers. According to the latest Aetna Provider Survey, 74% of providers identified administrative burden as the top challenge facing clinical staff today, and nearly one-third (31%) cited prior authorization management as the single largest contributor.
By reducing this burden, Aetna can help clinicians unlock more time for patient care. In fact, 30% of Aetna Provider Survey respondents believed they could save more than an hour and 80% expect to save more than 30 minutes daily on administrative tasks through technology solutions such as bundles.
Aetna expects to expand eligibility to Medicare and Commercial members in the first half of 2027.
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About Aetna
Aetna, a CVS Health business, serves an estimated 37 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care professionals, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).
About CVS Health
CVS Health is a leading health solutions company simplifying health care one person, one family and one community at a time. As of June 30, 2026, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics and a leading pharmacy benefits manager with approximately 87 million plan members. The Company also serves an estimated 37 million people through a broad range of health insurance products and related services. The Company’s integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.
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Phil Blando
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Phillip.Blando@CVSHealth.com
1Providers in OK, IL, MD, NJ, VA, FL, KY, WV that utilize the Eviti portal to submit prior authorizations.
2Aetna Data Sciences