UnitedHealth and Cigna Reduce Prior Authorization Requirements for Several Plans

October 1,2023 –  To help reduce the administrative burden on health care professionals and their staff, UnitedHealth Group Inc., the largest commercial insurer in the U.S., will implement a two-phased approach to eliminate the prior authorization requirement for several non-urgent surgeries and procedures.

The removals will take effect September 1st and November 1st across the vast majority of UnitedHealth plans. Together, the code removals will account for nearly 20% of UnitedHealth’s overall prior authorization volume. In 2024, UnitedHealth will implement a national Gold Card program for provider groups that meet eligibility requirements. Qualifying provider groups will follow a simple administrative notification process for most procedure codes, rather than the prior authorization process.

Cigna Healthcare also recently announced plans to remove prior authorization from 25% of medical services in their commercial plans, bringing the total number of prior authorization removals to more than 1,100 since 2020.  In addition, Cigna plans to eliminate nearly 500 codes from its Medicare Advantage plans before the end of this year.