UnitedHealthcare (UHC) is the largest health insurer in the United States, covering more than 29 million people, according to the American Medical Association (1). Unfortunately, as CNBC reported last year, it has also become the “face of America’s health insurance frustrations” (2).
The shooting death of the company’s CEO, Brian Thompson, in December 2024, brought the intense frustrations people have with universal health coverage. Indeed, his death sparked calls for reform and criticism of the insurance industry’s focus on profits over people.
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UHC was even sued by shareholders (3) for allegedly misrepresenting the impact of the public backlash on its business, which shareholders said caused a sharp drop in share price.
Now, however, UnitedHealthcare has taken a positive step by announcing a new policy that will reduce bureaucracy and make it easier for some patients to get the medical services they need.
UnitedHealthcare Makes Major Change to Open Access to Care
UnitedHealthcare issued a press release on May 5 (4), announcing the big change that many policyholders will welcome. The insurer said it is eliminating prior authorization requirements for 30% of health care services that previously required approval.
A complete list will soon be available on UHCProvider.com (5), and the changes will take effect in late 2026. UHC has already said that prior authorization requirements would be eliminated for:
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Echocardiograms and some other diagnostic tests.
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Some outpatient surgeries
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Some outpatient therapies
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Chiropractic care
“Prior authorization is an essential safeguard, but it should only be used when it truly protects patients and improves care,” UHC CEO Tim Noel said in the statement announcing the change.
“Eliminating these requirements is one more way we are working to make it easier for patients to get the care they need when they need it and ensure doctors can spend more time with their patients. We are committed to further improving and refining our processes to make reviews faster, simpler and more efficient.”
It’s worth noting that UHC had the highest rejection rates in the industry in the past, according to a ValuePenguin report (6). A Senate report (7) also criticized the insurer for high rates of denying nursing care to stroke victims in its Medicare Advantage plans, and it was sued (8) for using AI to deny claims.
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How does eliminating prior authorizations help patients?
As the Alabama Department of Insurance explains (9), prior authorization means that your doctor must obtain permission from your health insurer before he or she can provide you with health care services or prescribe prescription medications. If the doctor does not obtain this prior authorization, the care will not be covered.
When an insurer authorizes care, it is supposed to make the approval decision by verifying whether the care is medically necessary, safe, or cost-effective. However, many people believe that these decisions should be made by a doctor, not an insurance company.
And a 2024 survey (10) by the American Medical Association also found some surprising statistics about prior authorization. Specifically:
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93% of doctors reported delays in care when a procedure required prior authorization
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82% reported that prior authorization requirements lead patients to abandon treatment plans in at least some cases.
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31% said prior authorization criteria are rarely or never based on evidence.
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94% said PA requirements have a slight or significant impact on clinical outcomes.
The insurer’s decision is also part of a broader trend, as The Hill (11) reports that several major insurers responded to pressure to change prior authorization rules last year with a pledge to reform the process.
For now, UHC policyholders should check the company’s website for the full list of services. And anyone purchasing health insurance coverage can check the Summary of Benefits and Coverage (SBC) (12) or the insurer’s website for the prior authorization list. That way, you’ll know in advance how often your insurer will require permission before receiving care recommended by your doctor.
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Article sources
We rely only on verified sources and credible third-party reports. For more details, see our ethics and guidelines.
American Medical Association (1), (10); CNBC (2), (3); UnitedHealthcare (4), (5); ValuePenguin(6); United States Senate Committee on Homeland Security and Governmental Affairs (7); STAT News (8); Alabama Department of Insurance (9); The Hill (11); Cigna (12)
This article originally appeared on Moneywise.com with the title: Major US Health Provider Eliminates Prior Authorization for 30% of Services, and 93% of Doctors Say It’s Long Overdue
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
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