UnitedHealthcare announced on Tuesday that it is making sweeping changes to prior authorization requirements.
The company said it is eliminating prior authorization requirements for 30% of medical services and pledged to implement the changes by the end of 2026. The development comes after the Trump administration pressured the health industry to reform prior authorization and is particularly notable because UnitedHealthcare is the United States’s largest health insurer.
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“Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care,” UnitedHealthcare CEO Tim Noel said. “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.”
The Department of Health and Human Services made a major push last year for insurance companies to cut red tape in the process. At the time, Secretary Robert F. Kennedy Jr.’s office said UnitedHealthcare was among several large insurers that voluntarily committed to making prior authorization changes to be implemented across private insurance, Medicare Advantage, and Medicaid.
The agreement from UnitedHealthcare came after the company’s previous CEO, Brian Thompson, was gunned down on the streets of New York City by a suspect who railed against the healthcare industry in his alleged manifesto.
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, alluded to the 2024 murder when the Trump administration announced UnitedHealthcare and a slew of other insurers had agreed to reform prior authorizations.
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“There’s violence in the streets over these issues,” Oz said during a press conference last June. “This is not something that is a passively accepted reality anymore — Americans are upset about it.”
Prior authorization is a tool insurance companies use to verify that treatment, tests, procedures, drugs, and other healthcare services are necessary before agreeing to cover them. Care can be approved or denied depending on the outcome of the often lengthy process.
