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UnitedHealthcare removing prior approval for most pediatric services
The insurer said the changes will remove pre-approvals for many pediatric services while keeping reviews for higher-complexity care.
- On Friday, UnitedHealthcare announced it will eliminate prior authorization requirements for two-thirds of healthcare services for members under 18 by year-end, affecting both commercial and Medicaid plans.
- This move follows industry-wide commitments from over 50 health insurers, including Cigna, Aetna, and Humana, to "streamline, simplify and reduce" prior authorization processes made last summer.
- UnitedHealthcare CEO Tim Noel said parents "should be able to spend less time" navigating the system, as the company removes pre-approval for diagnostic imaging, sleep studies, and routine surgeries.
- While removing many requirements, UnitedHealthcare will continue requiring pre-approval for higher-risk treatments, experimental therapies, and specialty drugs, introducing waivers for procedures at leading comprehensive pediatric hospitals.
- Aetna recently reported it has standardized 88% of its prior authorization volume, while UnitedHealthcare anticipates over 70% of its authorization requests will follow standardized submission processes by year-end.
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UnitedHealthcare Scales Back Prior Authorization Requirements for Pediatric Care
UnitedHealthcare is set to eliminate about two-thirds of prior authorization requirements for children it covers by the end of the year. The insurer said on Friday that it will remove prior authorization for a wide range of services for members under 18, including certain diagnostic tests, routine surgeries, and specialty care spanning cardiology, neurology, pulmonology, and orthopedics. UnitedHealthcare also said it will introduce “authorizatio…
·New York, United States
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Total News Sources22
Leaning Left2Leaning Right1Center18Last UpdatedBias Distribution86% Center
Bias Distribution
- 86% of the sources are Center
86% Center
C 86%
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