UnitedHealthcare to remove prior authorisation for 30 per cent of services by 2026
Chief Executive Tim Noel says the move allows doctors to focus on care, though a full list of affected services is yet to be published.
UnitedHealthcare has announced plans to eliminate prior authorisation requirements for 30 per cent of health care services that previously mandated approval. The insurer, which covers more than 29 million people, stated the changes are scheduled to take effect by the end of 2026.
Chief Executive Tim Noel described the policy shift as a commitment to ensuring patients receive necessary care without unnecessary administrative hurdles. He noted that the move would allow doctors to spend more time with their patients rather than navigating bureaucratic processes. Specific services included in the initial announcement encompass echocardiograms and certain other diagnostic tests, with a comprehensive list to be published on UHCProvider.com.
The decision follows sustained criticism of the prior authorisation model, which requires medical practitioners to obtain permission from an insurer before providing a service or prescribing medication. A 2024 survey conducted by the American Medical Association highlighted the severe impact of these delays on care delivery. The findings revealed that 93 per cent of doctors reported care delays when procedures required prior authorisation, while 82 per cent noted that patients abandoned treatment plans as a result.
UnitedHealthcare has previously faced scrutiny regarding its handling of claims and public perception. Reports have indicated the insurer held the highest denial rates in the industry and faced shareholder lawsuits alleging misrepresentation of public backlash and its effect on stock performance. Critics have also pointed to the use of artificial intelligence in denying claims, a practice that has drawn regulatory attention from bodies such as the U.S. Senate Committee on Homeland Security and Governmental Affairs.
Despite these challenges, the new policy aligns with a broader industry trend where major insurers have pledged to reform prior authorisation processes in response to public and regulatory pressure. The insurer emphasised that prior authorisation remains an essential safeguard but should only be utilised when it genuinely protects patients and improves care outcomes.
As the policy moves toward implementation, policyholders are advised to monitor the insurer's website for the full scope of services affected. Consumers purchasing health insurance coverage can also consult the Summary of Benefits and Coverage or the insurer's website to understand how often prior authorisation will be required for specific treatments.
