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UnitedHealthcare said Tuesday it will eliminate “prior authorization” requirements for 30% of medical services that previously required approval from insurers, a policy shift that could eliminate red tape and speed up patient access to care.
The move comes as the health insurance industry faces pressure to limit prior authorizations, the process by which health care providers such as doctors or hospitals get approval from a patient’s insurance company to provide care.
Prior authorizations have long been criticized because they require significant time from doctors’ offices and impede patients’ access to care, with the American Medical Association finding that such offices spend an average of 12 hours a week seeking approval from insurance companies for medical treatments.
Critics say this time is better spent providing medical care, while some patients report Denied treatment by their insurance company.
UnitedHealthcare, the largest health insurance company in the United States, said in a statement that 2% of the medical services covered by its policies require prior authorization. About 92% of these were approved within 24 hours, the company said.
“Prior authorization is an important safeguard, but it should only be used when it truly protects patients and improves care,” UnitedHealthcare CEO Tim Noel said in a statement. “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 physicians can spend more time with their patients.”
Former UnitedHealth Group CEO Brian Thomson shot December 2024. Shooting suspect Luigi Mangione is awaiting trial In federal and state courts.
Which treatments will no longer require prior authorization?
UnitedHealthcare said the following procedures will no longer require prior authorization:
- Choose outpatient surgery
- some diagnostic tests, such as echocardiography
- some outpatient treatments
- some chiropractic care
The company said in a statement that it will post a full list of services on UHCProvider.com before the changes take effect.
When will this take effect?
UnitedHealthcare said it will implement the changes by the end of 2026.
Do other health insurance companies reduce prior authorizations?
Last year, a group of insurance companies represented by AHIP, the trade association for the health insurance industry, said some of its largest members would take measures Simplify prior authorization.
These include many Blue Cross Blue Shield insurance companies, such as Blue Cross Blue Shield of California, as well as large insurance companies such as Humana, Kaiser Permanente and UnitedHealthcare.
