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UnitedHealthcare’s prior authorization cuts begin

The first wave of UnitedHealthcare’s prior authorization cuts began Sept. 1.

In August, the payer released details of its plan to eliminate 20 percent of its current prior authorization. The cuts are coming across two waves. The second phase will begin Nov. 1.   

See the lists of eliminated codes below: 

“Prior authorizations help ensure member safety and lower the total cost of care, but we understand they can be a pain point for providers and members,” Anne Docimo, MD, chief medical officer of UnitedHealthcare said in a March 29 news release announcing the plans. “We need to continue to make sure the system works better for everyone, and we will continue to evaluate prior authorization codes and look for opportunities to limit or remove them while improving our systems and infrastructure. We hope other health plans will make similar changes.”

UnitedHealthcare will also implement a national gold card plan in 2024. The company said it will release more information about that program later this year. 

Shortly after UnitedHealthcare detailed the cuts, Jack Resneck Jr., MD, immediate past president of the American Medical Association, told Becker’s the organization was “cautiously optimistic that patients and physicians will begin to feel some relief from the prior authorization burden” under the payer’s plans. 

 Medical Group Management Association Director of Government Affairs Claire Ernst told Becker’s the organization is encouraged that the new policy “appears to address the profoundly detrimental effect that prior authorization requirements have on medical groups and their patients. We urge UHC to continue rolling out policies that put physician practices in the driver’s seat of their patients’ care.”

UnitedHealthcare is not the only payer that has announced prior authorization cuts. Cigna Healthcare said Aug. 24 that it has removed prior authorization requirements for more than 600 medical procedures, cutting the number of prior authorizations it requires by 25 percent.