April 2, 2023 – The United States' largest health insurer says it can not require lengthy paperwork called prior authorization for a lot of forms of health care starting later this yr.
UnitedHealthcare has the Notice Last week, the federal government announced it could cut the variety of authorisations by 20% as a growing variety of doctors, patients and politicians said the method was resulting in harmful delays or denials of treatment.
“We are not deaf to the complaints out there,” said Philip Kaufman, Chief Growth Officer at UnitedHealthcare The Wall Street Journal“We have taken a close look at ourselves and this process.”
The insurer also announced that it can launch a “Gold Card” program next yr that may allow already licensed healthcare providers to waive prior authorization for many treatments.
Other insurers resembling Cigna and Aetna have also announced changes resembling automating or simplifying the approval process, diary reported.
Prior authorization requires a healthcare provider to prove the necessity for a treatment, procedure or medical device. This often involves paperwork. The process often takes a number of weeks or less, but can sometimes drag on for months. Many providers and hospitals employ staff to fill out the paperwork and send it to insurers.
More than 9 in 10 doctors report that prior authorizations have delayed an individual’s access to essential medical care, in accordance with a Opinion poll of 1,001 physicians conducted by the American Medical Association. One in three physicians within the survey also said that lengthy bureaucracy harms people, resembling by resulting in hospitalization, a life-threatening event, or “disability or permanent physical impairment, a congenital anomaly or birth defect, or death.”
Some within the medical community would love to abolish this process altogether.
“We all know that requiring prior authorizations really just creates more bureaucracy within the insurance company as well as within each healthcare provider's practice because we now need people to fill out these prior authorization forms, waste time calling their 1-800 number to talk to someone who has no clinical knowledge, and then get told we need to talk to someone else who actually has medical knowledge about why these procedures are necessary. This in turn leads to increased costs because we all have to hire more people to handle these unnecessary requests,” said Linda Lee, MD, medical director of endoscopy at Brigham and Women's Hospital in Boston and associate professor of medication at Harvard Medical School, Becker's ASC review.