Our commitment to easing prior authorization

UnitedHealthcare is taking industry-leading steps to make healthcare simpler and more affordable for patients and providers, while raising the bar for transparency and accountability across the marketplace.

In fall 2026, UnitedHealthcare will eliminate 30% of its current prior authorization volume. This includes select outpatient surgeries, certain diagnostic tests such as echocardiograms, and some outpatient therapies and chiropractic care.

A comprehensive list of affected services is available on UHCProvider.com.

As part of this effort, UnitedHealthcare is removing two-thirds of authorization requirements for members under age 18 by year’s end. The company is eliminating prior authorizations in pediatric care for many diagnostic services, routine surgical procedures, and specialty care services across pediatric subspecialties such as cardiology, neurology, pulmonology and orthopedics.

UnitedHealthcare in April announced additional actions to support rural communities by accelerating payments to select hospitals and exempting many rural providers nationwide from prior authorization requirements.

These steps are designed to improve financial stability for rural hospitals, reduce administrative strain on care teams, and help ensure patients can access high quality care close to home. By fall 2026, this program will expand to approximately 1,400 rural hospitals and their associated practitioners, including all Critical Access Hospitals. Of note, April’s announcement builds on a four-state pilot UnitedHealthcare introduced in January.

UnitedHealthcare has also been a leader in advancing industrywide improvements to prior authorization processes. We recently championed an industry effort to standardize electronic prior authorization submission requirements, laying the groundwork for greater automation and interoperability, and a more seamless experience for care providers and patients.

More than 70% of UnitedHealthcare’s prior authorizations will be part of the new standardized submission process by year‑end.

In March, we publicly reported prior authorization metrics and maintain the data on our website along with additional context to help care providers, members and the public better understand how prior authorization is used.

All these efforts reflect UnitedHealthcare’s continued focus on reducing administrative complexity, improving the care experience, and helping people access care more easily and efficiently. This work is grounded in our strategy to modernize how we partner with the people who rely on us — strengthening trust, reducing friction and building more collaborative relationships.

These actions build on several years of reform:

• In 2023, UnitedHealthcare removed nearly 20% of our total prior authorization volume for services that already demonstrate consistent adherence to evidence-based guidelines and are almost always approved.

• In fall 2024, we introduced our first-of-its-kind national Gold Card program, reducing prior authorizations for provider groups who consistently adhere to evidence-based care guidelines.
  • Since the program began, we’ve since seen an 80% increase in the number of provider groups that have qualified for our Gold Card program. The increase reflects another year of prior authorization submissions and our continued transparency in sharing program criteria and qualification data in the provider portal.
  • In 2025, we surveyed our most active Gold Card users, and 94% of respondents said they are satisfied overall. That same percentage agreed that the program has reduced administrative tasks.
• In 2025, we removed prior authorization requirements representing nearly 10% of our total prior authorization volume.

• We continue to work toward achieving the AHIP commitments as part of an industrywide effort to streamline, simplify and reduce prior authorizations for patients and providers.

Combined, these initiatives reflect our ongoing focus on reducing administrative complexity, improving the care experience and helping people access care more easily and efficiently — while strengthening trust and accountability across the healthcare system.