UnitedHealthcare announced it will cut prior authorization requirements for 30% of medical services that currently require insurer approval, aiming to reduce administrative barriers and expedite patient care. The changes, set to be implemented by the end of 2026, reflect growing pressure on health insurers to limit the use of prior authorizations.
Scope of Changes and Impacted Services
Prior authorization is a process where health care providers request approval from insurers before delivering certain treatments or tests. UnitedHealthcare, the largest health insurer in the U.S., currently requires prior authorization for about 2% of covered medical services. The company states that nearly 92% of these requests are approved within 24 hours.
Under the new policy, prior authorization will no longer be required for select outpatient surgeries, some diagnostic tests including echocardiograms, certain outpatient therapies, and chiropractic care. UnitedHealthcare plans to publish the full list of services exempt from prior authorization at UHCProvider.com before the changes take effect.
Context and Industry Trends
Prior authorizations have long been criticized for the administrative burden they place on physicians and delays they cause in patient treatment. The American Medical Association reports that medical offices spend an average of 12 hours per week managing prior authorizations, time that many argue could be better spent on direct patient care.
Other major insurers have also announced initiatives to reduce prior authorization requirements. Last year, several large health plans, including Blue Cross Blue Shield affiliates, Humana, and Kaiser Permanente, pledged to streamline or lessen these approvals under the Health Insurance Plans (AHIP) association.
Statements from UnitedHealthcare
Tim Noel, CEO of UnitedHealthcare, emphasized the role of prior authorization as a safeguard but stated it should be used only when it protects patients and improves care quality. Noel said, “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.”
Why it matters
This move could significantly reduce delays in patient care and administrative workload for healthcare providers, potentially improving health outcomes and patient satisfaction. It also responds to widespread calls from medical professionals for insurers to streamline procedures that hinder timely access to necessary treatments.
Sources
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