UnitedHealthcare said on Tuesday it is eliminating “prior authorization” requirements for 30% of medical services that previously required insurer approval, a policy shift that could eliminate red tape and speed access to patient care.
The move comes amid pressure on the health insurance industry to limit prior authorizations, the process by which health care providers such as doctors or hospitals obtain approval from patients’ insurance carriers to deliver care.
Prior authorizations have long drawn criticism for the time they require of physicians’ offices and for hindering patients’ access to care, with the American Medical Association finding that such offices spend an average of 12 hours per week seeking insurer approval for medical treatments.
Critics say those hours would be better spent providing medical care, while some patients report being denied treatment by their insurance companies.
UnitedHealthcare, the largest U.S. health insurer, said in a statement that prior authorization is required for 2% of the medical services covered under its policies. About 92% of those are approved within 24 hours, the company said.
“Prior authorization is an essential safeguard but 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 doctors can spend more time with 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.
