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UHC Unit to reduce use of Prior Authorizations

7 Apr 2023 9:02 AM | Addie Thompson (Administrator)

March 29 (Reuters) - UnitedHealth Group Inc (UNH.N) said on Wednesday its insurance unit will reduce the use of prior authorization process by 20% for some non-urgent surgeries and procedures.

Under this process, Healthcare providers get coverage approval for certain non-emergency procedures.

The reductions will begin in the third quarter and will continue through the rest of the year for most commercial and Medicare Advantage as well as Medicaid businesses.

The company will implement in early next year a national Gold Card Program for care providers that meet eligibility norms, ending the need for prior authorization for most procedures. It would apply for most UnitedHealthcare members.

"We will continue to evaluate prior authorization codes and look for opportunities to limit or remove them while improving our systems and infrastructure," said Anne Docimo, chief medical officer of UnitedHealthcare.

The company said it plans to remove prior authorization requirements in certain types of medical equipment like orthopedic support devices and some genetic tests used for diagnosis.

The U.S. Centers for Medicare & Medicaid Services had last year issued a proposed rule to simplify the process, which doctors said causes administrative burden to patients and doctors.

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