UnitedHealthcare announced it will eliminate prior authorization requirements for 30% of medical services that previously necessitated insurer approval. This significant policy shift aims to reduce administrative burdens and expedite patient access to necessary care.
Prior authorization has faced considerable backlash for the delays it causes in patient treatment. The American Medical Association highlighted that healthcare providers spend an average of 12 hours each week seeking approval from insurance companies, time that critics argue would be more effectively spent on patient care. Additionally, some patients have reported being denied necessary treatments by their insurers.
As the largest health insurer in the United States, UnitedHealthcare indicated that only 2% of medical services covered under its plans currently require prior authorization, with approximately 92% of those requests being approved within 24 hours. CEO Tim Noel emphasized the importance of utilizing prior authorization only as a safeguard that genuinely protects patients and enhances care. He stated, “Eliminating these requirements is one more way we are working to make it easier for patients to get the care they need when they need it and ensure doctors can spend more time with their patients.”
The specific medical treatments that will no longer require prior authorization include select outpatient surgeries, certain diagnostic tests like echocardiograms, various outpatient therapies, and some chiropractic care. UnitedHealthcare plans to release a comprehensive list of these services on its provider portal before the changes come into effect.
These changes are expected to be implemented by the end of 2026. Other insurers are also examining their prior authorization processes; a coalition of major health insurers, represented by the trade association AHIP, announced intentions to streamline these authorization requirements. Among those insurers are several Blue Cross Blue Shield affiliates and well-known providers such as Humana and Kaiser Permanente.
