finance
UnitedHealthcare to Cut Two-Thirds of Prior Approvals for Patients Under 18
UnitedHealthcare said it will remove two-thirds of authorization requirements for members under age 18 by the end of 2026. The change applies to commercial and Medicaid plans and covers many diagnostic services, routine procedures, and specialty care.
May 29, 7:00 AM·1m read1 source
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UnitedHealthcare announced it will remove two-thirds of prior authorization requirements for health plan members under age 18 by the end of this year. The insurer said the change applies to its commercial and Medicaid plans. It covers many diagnostic services, routine surgical procedures, and specialty care in cardiology, neurology, pulmonology, and orthopedics.
Last summer more than 50 health insurers, including UnitedHealthcare, Cigna, Aetna, and Humana, pledged through AHIP and the Blue Cross Blue Shield Association to streamline prior authorization. Those groups said the plans cover more than 250 million Americans. Aetna reported last month that it had standardized 88 percent of its prior authorization volume.
UnitedHealthcare said it will also issue authorization waivers for certain procedures at leading comprehensive pediatric hospitals. The company did not name the facilities. It will continue to require pre-approval for experimental treatments, specialty drugs, and services required by government regulation.
"Parents should be able to spend less time having to navigate the health system and more time focusing on their children as they get the care they need," said UnitedHealthcare chief executive officer Tim Noel.
