UnitedHealthcare to eliminate 30% of prior authorization requirements
UnitedHealthcare announced it will eliminate authorization requirements for 30% of healthcare services that previously required insurer approval by the end of 2026. The changes will affect select outpatient surgeries, diagnostic tests including echocardiograms, and certain outpatient therapies and chiropractic care.
The company currently requires prior authorization for 2% of its medical services, with approximately 92% of submitted authorizations approved within 24 hours on average. UnitedHealthcare states it has fewer prior authorization requirements than other insurers within Medicare Advantage.
"Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care," said Tim Noel, CEO of UnitedHealthcare. "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."
The announcement follows several recent initiatives by UnitedHealthcare. In April, the company supported standardizing electronic prior authorization submission requirements across the insurance industry, with over 70% of its prior authorizations expected to use the new standardized process by year-end.
UnitedHealthcare also announced expanded support for rural healthcare communities, exempting many rural care providers from prior authorization requirements. The program will extend to approximately 1,500 rural hospitals and associated practitioners by fall 2026, including all Critical Access Hospitals.
Additional recent changes include expanding coverage for doula care, affecting about 7.2 million members through employer health plans by January 2027, and pledging to eliminate profits from individual ACA offerings in 2026.
UnitedHealthcare is part of UnitedHealth Group (NYSE: UNH). A complete list of services losing prior authorization requirements will be available on UHCProvider.com before the changes take effect, according to the company's press release.
