Health insurance giant UnitedHealthcare said on May 5 it will eliminate prior-approval requirements for 30% of health care services amid complaints that administrative tasks delay or deny people care.
The Minnesota-based insurer is one of several large insurers that have vowed to reduce the use of “prior authorizations” to review requests before letting doctors or other medical providers bill for health care services or prescriptions. Doctors and patients have long criticized prior authorizations, saying in surveys and government oversight reports that the practice routinely delays or denies care.
UnitedHealthcare said it will eliminate prior authorizations on some outpatient operations, diagnostic tests such as echocardiograms, outpatient therapies, and chiropractic care by the end of 2026. The insurer said prior authorizations are used about 2% of UnitedHealthcare-covered medical services, and when requests are submitted, 92% are approved in less than one day.
In a statement, UnitedHealthcare CEO Tim Noel said the move would make it easier for patients to receive care and doctors to spend more time with patients.
“We are committed to further improving and refining our processes to make reviews quicker, simpler and more efficient,” Noel said.
A Broader Industry Push
In June, UnitedHealthcare, Blue Cross Blue Shield, Cigna, Kaiser Permanente, Humana, and other insurers joined Trump administration health officials to announce they would cut down and streamline the use of prior authorizations. Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Mehmet Oz said the insurance companies voluntarily pledged to make such changes.
But Oz said the federal government could adopt rules and regulations to enforce change if the insurance companies don’t make promised improvements.
The insurers said the changes would apply to 257 million Americans covered by private commercial insurance, Medicare Advantage, and Medicaid managed care plans.
In March, UnitedHealthcare announced it would publicly report data on prior authorizations and post data on a company website.
Doctors vs. Insurers
Doctors complain that prior authorization is burdensome and often used to delay or deny medically necessary medical care for patients. In an American Medical Association survey of 1,000 physicians, 93% of doctors reported that prior authorization delayed care for patients.
Insurance companies counter that authorizations are a vital tool to prevent unnecessary tests and medical care that inflate medical bills for families. Consumers often must pay a portion of medical bills through insurance plan copayments, coinsurance, or deductibles — the amount a person must pay before insurance coverage kicks in.