UnitedHealth Group and CVS Health said on Friday that they have standardized data and submission requirements for more than half of their prior authorization processes, as part of a broader industry push to reduce delays and administrative burdens for patients and healthcare providers.
U.S. health insurers, which have faced growing scrutiny to simplify approval requirements for medications and medical services, are working to follow through on commitments made last year to cut red tape and improve transparency.
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- UnitedHealthcare, the insurance arm of UnitedHealth Group, said more than 70% of prior authorization requests will be included in the standardized process by the end of the year.
- The process will apply across its commercial plans as well as government-backed programs like Medicare Advantage and Medicaid.
- CVS Health said its Aetna insurance unit has already standardized 88% of its prior authorization volume.
- According to AHIP, the standardized approach will cover commonly authorized services such as orthopedic surgeries and imaging procedures, including CT scans and MRIs.
- UnitedHealthcare aims to improve predictability, reduce administrative rework, and cut down on requests for additional information by standardizing required data.
- The company also plans to expand the program to more medical services while continuing to reduce the number of procedures requiring prior approval.
- UnitedHealthcare clarified that these changes will not impact coverage rules or the medical criteria used to approve or deny care.
