UnitedHealth Shares More Details About Prior Authorization Cutbacks

Several months after UnitedHealthcare first revealed that it would eliminate “nearly 20%” of current prior authorizations, the health insurance giant has outlined which specific procedure codes will be subject to the PA-elimination effort.

In an Aug. 1 bulletin to health care providers, UnitedHealthcare said it will remove PA requirements from five of its benefit plans in a two-phased approach. On both Sept. 1 and Nov. 1, the insurer will eliminate PA for select sets of procedure codes in its Medicare Advantage, commercial, Oxford and individual exchange plans. The company will eliminate a swath of PA codes in its UnitedHealthcare Community Plan (for Medicaid enrollees) on Nov. 1.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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