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<\/a><\/a>\nThe company is eliminating prior authorizations for many diagnostic services, routine surgical procedures and specialty care services across pediatric subspecialties such as cardiology, neurology, pulmonology and orthopedics.<\/p>
\nUnitedHealthcare is also introducing authorization waivers for certain procedures performed at leading comprehensive pediatric hospitals, reflecting these facilities\u2019 consistent use of well-established care practices. These hospitals represent a broad network of nationally recognized pediatric centers spanning medical and surgical specialties.<\/p>
\n\u201cParents should be able to spend less time having to navigate the health system and more time focusing on their children as they get the care they need,\u201d said Tim Noel, CEO of UnitedHealthcare. \u201cThese changes are part of our broader efforts to simplify healthcare and allow families \u2014 and their doctors and nurses \u2014 to pursue routine care with far fewer administrative steps, while higher-risk procedures continue to undergo reviews.\u201d<\/p>
\nUnitedHealthcare is conducting a rigorous, data-driven review of all pediatric prior authorization requirements to determine which services can be safely removed while maintaining high standards of clinical quality and patient safety. The company will eliminate pre-approval for certain pediatric services, including some diagnostic imaging; reviews of where care is provided; sleep studies; routine outpatient testing; and select surgical and therapeutic procedures that are consistently approved. UnitedHealthcare will continue to require pre-approval for services with higher clinical complexity or variability, including experimental treatments, specialty drugs and when required by government regulation.<\/p>
\nThe changes apply to UnitedHealthcare\u2019s commercial and Medicaid plans.<\/p>
\nRecent efforts to simplify the healthcare system<\/b><\/p>
\nToday\u2019s announcement builds on an ongoing effort<\/a> to improve and simplify patient and care provider experiences and lower costs for consumers, including:<\/p> \nOn May 11, 2026, Optum Rx announced<\/a> the industry\u2019s first fully transparent, fee-based pharmacy care model. Every Optum Rx client will be offered a pricing structure with monthly, clearly defined fees per member that are independent of manufacturers\u2019 list prices or prescription volume, eliminating spread pricing and similar practices. In addition to new pricing structures, Optum is also launching digital tools that let consumers compare prices and see medication costs before visiting the pharmacy.<\/p> \nOn April 24, 2026, UnitedHealthcare championed<\/a> 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\u2019s prior authorizations will be part of the new standardized submission process by year\u2011end.<\/p> \nOn April 20, 2026, UnitedHealthcare announced<\/a> that it is expanding support for rural healthcare communities by accelerating payments to more select hospitals nationwide and exempting many rural care providers from prior authorization requirements. These actions are designed to improve financial stability for rural hospitals, ease strain on care teams and help ensure patients in rural communities can access high\u2011quality care when and where they need it. By fall of 2026, this program will expand to approximately 1,500 rural hospitals and their associated rural practitioners nationwide, including all Critical Access Hospitals.<\/p> \nOn March 31, 2026, UnitedHealthcare publicly reported prior authorization metrics and maintains the data on its website<\/a>, along with additional context to help care providers, members and the public better understand how prior authorization is used.<\/p> \nOn March 16, 2026, UnitedHealthcare expanded coverage for doula care<\/a> to support families throughout pregnancy, birth and the postpartum period. By Jan. 1, 2027, about 7.2 million members could have access to the offering through employer health plans.<\/p> \nIn January, the company pledged to voluntarily eliminate and rebate any profits from its individual ACA offerings in 2026.<\/p> \nTogether, these efforts reflect UnitedHealth Group\u2019s continued focus on reducing administrative complexity, improving the care experience and helping people access care more easily and efficiently.<\/p> \nAbout UnitedHealthcare<\/span><\/b><\/p> \nUnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the healthcare experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with physicians, care professionals, hospitals and other care facilities. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified healthcare company. For more information, visit UnitedHealthcare at www.uhc.com<\/a> or follow UnitedHealthcare on LinkedIn<\/a>.<\/p>\n