The goal of the new rule is 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.
Prior authorization is often cited as the largest burden in patient care by healthcare specialists, causing states and payers alike to draft plans to eliminate requirements.
“The prior authorization issues that we face every day with commercial payers is overwhelming. Many of the rules seemingly change day to day, and the payer policies dictate provider decisions in a negative way many times. On top of that, many payer policies aren’t up-to-date with new research, and we are chasing old assumptions,” Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker’s.
The Sept. 1 elimination includes codes for several major procedures across various specialties, including gastroenterology and spinal care.
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