UnitedHealth’s insurance unit said on May 29 that it will eliminate prior approval requirements for about two-thirds of its healthcare services for members under age 18, a move that could ease one of the most common bottlenecks families face when trying to get care for children.
UnitedHealthcare said the change will cover many diagnostic services, routine surgical procedures and specialty care services, including pediatric subspecialties such as cardiology, neurology, pulmonology and orthopedics. The insurer also said it will create authorization waivers for certain procedures performed at leading comprehensive pediatric hospitals.
Tim Noel, the company executive quoted on the change, said parents should be able to spend less time navigating the health system and more time focusing on their children as they get the care they need. That message lands at a moment when insurers are under pressure to show they are doing more than making public promises about paperwork reduction.
The announcement follows a similar step last month, when UnitedHealth and CVS Health said they had standardized data and submission requirements for more than half of their prior authorizations. UnitedHealthcare said more than 70% of its prior authorizations will be part of the new standardized submission process by the year's end.
UnitedHealthcare said it is still conducting a rigorous, data-driven review of all pediatric prior authorization requirements to determine which services can be safely removed. That leaves open how far the company will go beyond Thursday's changes and which pediatric services will still need advance approval before treatment can begin.
The policy shift is part of broader insurer efforts to reduce delays and paperwork amid complaints from patients and doctors. U.S. health insurers have been working to deliver on commitments made last year to cut excessive administrative steps that can slow care or, in some cases, keep people from getting it at all. For families with children, the immediate test will be whether the new rules actually shorten the wait between a doctor’s recommendation and the care that follows.
