UnitedHealthcare Axes Routine Prior Auths for Over 1,700 Procedures

UnitedHealthcare is making significant changes to its prior authorization review process. Starting October 1, over 1,700 procedures will no longer require routine prior authorization reviews. This includes biopsies of the insides of people's noses and ears, as well as various colonoscopy-related procedures.

The company has also announced that it will stop requiring advance notification for capsule endoscopies, diagnostic colonoscopies, surveillance colonoscopies, and esophageal and stomach scoping efforts. Additionally, UnitedHealthcare is making its physician prior authorization portal easier to use.

These changes may reduce the burden on physicians and employers, who often complain about delayed or denied coverage requests. However, some experts warn that this could lead to overutilization of expensive or unnecessary care.

This move follows Dr. Mehmet Oz's statement at his confirmation hearing as administrator of the Centers for Medicare & Medicaid Services, where he expressed a goal to reduce prior authorization requirements. UnitedHealthcare has been working to voluntarily reduce the scope of prior authorization requirements, and this is another step in that direction.