UnitedHealthcare to drop prior approval across services from Oct. 1

  • UnitedHealthcare will eliminate prior authorization for services across several clinical specialties.
  • The insurer aims to remove authorization requirements for 30% of services by year-end.
  • A rural waiver begins November 1, while payments accelerate for about 1,400 hospitals.

UnitedHealthcare will eliminate prior authorization requirements for a broad range of services effective October 1, covering commercial plans, Medicare Advantage, Affordable Care Act individual insurance and some other plans. The changes span cardiology, genetic and laboratory testing, chiropractic care, physical, occupational and speech therapy, orthopedic and musculoskeletal procedures and other specialties. The insurer aims to eliminate prior authorization for 30% of healthcare services by the end of the year, responding to concerns that administrative requirements create paperwork and delay or deny care. UnitedHealthcare will also introduce a rural prior authorization waiver program on November 1, reduce administrative requirements for eligible rural hospitals and affiliated providers, and speed payments by up to 50% for about 1,400 rural hospitals and Critical Access Hospitals in the third quarter.

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