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UnitedHealthcare vows to cut down use of prior reviews for kids' care
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UnitedHealthcare said on May 29 it will cut down two-thirds of prior approval requirements by the end of 2026 for children the health insurance giant covers. Among the prior authorizations that UnitedHealthcare said would be reduced or cut: some diagnostic services, routine surgical procedures and specialty care such as cardiology, neurology, pulmonology and orthopedics. The move targeting red tape for doctors and families is part of the insurer's goal announced on May 5 to eliminate prior-approval requirements for 30% of health care services amid complaints that administrative tasks delay or deny people care. Doctors and patients have long criticized prior authorizations, in which an insurer reviews a request before letting doctors or other medical providers bill for health care services or prescriptions. Doctors say the administrative action routinely delays or denies care. Large insurers such as UnitedHealthcare, Blue Cross Blue Shield, Cigna, Kaiser Permanente and Humana have vowed to reduce the use of prior authorizations. UnitedHealthcare also said it would implement "authorization waivers" for some procedures at some pediatric hospitals. These waivers will be based on children's hospitals' "consistent use of well-established care practices," UnitedHealthcare said in a news release. Although UnitedHealthcare didn't name the hospitals that would qualify for such waivers, the insurer said the hospitals are part of a "broad network of nationally recognized pediatric centers spanning medical and surgical specialties." The insurer said it would eliminate pre-approval requirements for other pediatric services such as some diagnostic imaging, sleep studies and routine non-hospital testing. UnitedHealthcare will maintain pre-approval requirements for complex care and experimental treatments. The changes to reviews for children's care will apply to people who are covered by UnitedHealthcare's private insurance and Medicaid, the federal-state health care program for low income families and some with disabilities. As part of its previously announced push to reduce administrative hurdles for patients of all ages, UnitedHealthcare vowed to cut down prior authorizations on some outpatient operations, diagnostic tests such as echocardiograms, outpatient therapies, and chiropractic care by the end of 2026. This article originally appeared on USA TODAY: UnitedHealthcare cuts use of prior authorization for kids
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