Three major payers have cut prior authorization requirements in August:
1. On Sept. 1, UnitedHealthcare will begin its two-phased approach to eliminating prior authorization requirements. The new rule aims to eliminate prior authorizations planwide by 20 percent. On Sept. 1, codes will be eliminated for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plans.
The Sept. 1 elimination includes codes for several major procedures across various specialties, including gastroenterology and spinal care.
2. Cigna Healthcare is removing nearly 25 percent of medical services from prior authorization requirements, cutting more than 600 codes. Since 2020, Cigna has removed more than 1,100 medical services to simplify healthcare for customers and clinicians. Cigna also plans to remove 500 additional codes for Medicare Advantage plans later this year.
3. On Aug. 1, Humana rolled back prior authorization requirements for cataract surgery for Medicare Advantage beneficiaries in Georgia. The insurer started requiring pre-approval for the procedure a year ago.