UnitedHealth's insurance division has announced it will eliminate prior-approval requirements for approximately two-thirds of healthcare services for members under 18, effective immediately. The move comes after widespread backlash from patients and doctors over delays and administrative burdens.
The change covers many diagnostic services, routine surgical procedures, and specialty care across pediatric subspecialties including cardiology, neurology, pulmonology, and orthopedics. UnitedHealthcare also plans to introduce authorization waivers for certain procedures at leading comprehensive pediatric hospitals.
Tim Noel, CEO of UnitedHealthcare, said: 'Parents should be able to spend less time having to navigate the health system and more time focusing on their children as they get the care they need.' Noel took over the role after the 2024 assassination of his predecessor, Brian Thompson.
The company stated it is conducting a 'rigorous, data-driven review' of all pediatric prior authorization requirements to determine which services can be safely removed from the approval process. This follows last month's announcement that UnitedHealth and CVS Health had standardized data and submission requirements for more than half of their prior authorizations.
UnitedHealthcare anticipates that over 70% of its prior authorizations will be part of this new standardized submission process by the end of the year.
