UnitedHealthcare to Remove Two-Thirds of Authorization Requirements by Year-End
UnitedHealthcare is removing two-thirds of authorization requirements for members under age 18 by year's end. This move is the latest in a series of initiatives to simplify the healthcare system for providers and patients. The company is eliminating prior authorizations for many diagnostic services, routine surgical procedures and specialty care services across pediatric subspecialties such as cardiology, neurology, pulmonology and orthopedics. UnitedHealthcare is also introducing authorization waivers for certain procedures performed at leading comprehensive pediatric hospitals, reflecting these facilities' consistent use of well-established care practices. These hospitals represent a broad network of nationally recognized pediatric centers spanning medical and surgical specialties. UnitedHealthcare is conducting a rigorous, data-driven review of all pediatric prior authorization requirements to determine which services can be safely removed while maintaining high standards of clinical quality and patient safety. The company will eliminate pre-approval for certain pediatric services, including some diagnostic imaging; reviews of where care is provided; sleep studies; routine outpatient testing; and select surgical and therapeutic procedures that are consistently approved. UnitedHealthcare will continue to require pre-approval for services with higher clinical complexity or variability, including experimental treatments, specialty drugs and when required by government regulation. The changes apply to UnitedHealthcare's commercial and Medicaid plans.
