On Tuesday, UnitedHealthcare announced a significant policy change, stating it will remove “prior authorization” mandates for 30% of medical services that previously needed insurance approval. This adjustment aims to reduce bureaucratic hurdles and expedite patient care access.
This decision arises as the health insurance sector faces increasing demands to curb prior authorizations—a protocol where healthcare providers, including doctors and hospitals, must seek approval from insurers before delivering care.
Such authorizations have faced scrutiny for consuming valuable time from medical professionals and impeding timely patient care. The American Medical Association has highlighted that physician offices dedicate around 12 hours each week to securing insurer consent for medical procedures.
Critics argue that these hours could be more effectively used for direct patient care, while some individuals report that their insurance companies have denied them necessary treatments.
UnitedHealthcare, the nation’s largest health insurer, clarified in a statement that only 2% of the medical services covered under its policies require prior authorization, with approximately 92% gaining approval within a day.
“While prior authorization acts as a crucial protective measure, it should be applied solely to genuinely safeguard patients and enhance care,” remarked UnitedHealthcare CEO Tim Noel. “By eliminating these requirements, we aim to simplify the process for patients to access the care they need promptly and allow doctors to dedicate more time to their patients.”
Former UnitedHealth CEO Brian Thomson was shot and killed in December 2024. The suspect in the shooting, Luigi Mangione, is awaiting trial in both federal and state court.
Which treatments will no longer require prior authorizations?
UnitedHealthcare said the following procedures will no longer require prior authorization:
- Select outpatient surgeries
- Some diagnostic tests, such as echocardiograms
- Some outpatient therapies
- Some chiropractic care
In its statement, the company said it would post the full list of services at UHCProvider.com before the changes take effect.
When does this take effect?
UnitedHealthcare said it will implement the changes by the end of 2026.
Are other health insurers reducing prior authorizations?
Last year, a group of insurers represented by Health Insurance Plans (AHIP), a trade association for the health insurance industry, said some of its biggest members would take steps to streamline prior authorization.
They include many Blue Cross Blue Shield insurers, such as Blue Cross Blue Shield of California, as well as large insurers such as Humana, Kaiser Permanente and UnitedHealthcare.
