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UnitedHealthcare eliminates prior authorization for a broad range of medical services starting October 1

UnitedHealthcare announced that a broad range of medical services will no longer require prior authorization starting October 1. The insurer aims to eliminate prior authorization requirements for 30% of its healthcare services by the end of the year. These changes affect commercial plans, Medicare Advantage for older adults, and individual insurance under the Affordable Care Act. Specific services being removed from the authorization process include cardiology, oncology, genetic and laboratory testing, and orthopedic and musculoskeletal procedures. The move is intended to reduce administrative paperwork and allow patients and providers to focus more on care. The administration also influenced these changes through rule changes from the CMS. UnitedHealthcare is also implementing a rural prior authorization waiver program starting November 1, which will speed up payments for approximately 1,400 rural hospitals. Suzan K. DelBene stated that the plan is encouraging but argued that voluntary steps should not replace legislation. She called for the passage of the Improving Seniors’ Timely Access to Care Act to standardize rules and increase transparency.

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