UnitedHealthcare to Drop Prior Authorization for Hundreds of Medical Services
The change aims to reduce administrative burdens and speed up patient access to care.
UnitedHealthcare announced on Tuesday that it will eliminate prior authorization requirements for approximately 30% of medical services that currently require insurer approval.
Details of the Change
Services that will no longer require prior authorization include select outpatient surgeries, some diagnostic tests (e.g., echocardiograms), some outpatient therapies, and some chiropractic care. The full list will be published at UHCProvider.com before implementation.
The company stated that prior authorization applies to 2% of medical services covered under its policies, and about 92% of those are approved within 24 hours.
The changes will be implemented by the end of 2026.
Industry Context
Prior authorization has been criticized by physicians for the time it consumes. The American Medical Association reports physician offices spend an average of 12 hours per week seeking approvals. Critics argue those hours could be better spent on patient care, and some patients have reported being denied treatment.
In response to similar pressures, a group of insurers represented by AHIP (America's Health Insurance Plans) said last year that some major members, including Blue Cross Blue Shield of California, Humana, Kaiser Permanente, and UnitedHealthcare, would take steps to streamline prior authorization.