UnitedHealthcare announced on Friday (May 29) that it will significantly reduce prior authorization requirements for pediatric care by the end of the year. The move aims to simplify healthcare access for children under 18, cutting two-thirds of the current authorization mandates. This change is part of a broader initiative to address complaints about delays and administrative burdens associated with prior approvals.

According to UnitedHealth Group, the company will eliminate prior authorizations for many diagnostic services, routine surgical procedures, and specialty care services in pediatric subspecialties like cardiology, neurology, pulmonology, and orthopedics. Tim Noel, CEO of UnitedHealthcare, emphasized that these changes will allow parents to focus more on their children's health needs rather than navigating complex healthcare systems.

UnitedHealthcare will also introduce authorization waivers for certain procedures at leading comprehensive pediatric hospitals, which are recognized for their consistent use of established care practices. The company will maintain pre-approval requirements for services with higher clinical complexity, such as experimental treatments and specialty drugs.

The insurer is conducting a rigorous review to determine which services can safely be removed from prior authorization requirements while maintaining high standards of care. This initiative is part of UnitedHealthcare's ongoing efforts to improve patient and provider experiences and reduce costs, as noted in a statement from the company.

The changes will apply to both commercial and Medicaid plans. By the end of 2026, UnitedHealthcare plans to standardize more than 70% of its prior authorization submissions, enhancing automation and interoperability within the healthcare system.

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