On Friday, April 24, 2026, UnitedHealth and CVS Health announced that they have standardized data and submission requirements for more than half their prior authorizations (PAs). The PA process of US healthcare insurers has come under scrutiny and they are working to deliver on commitments that they made last year to cut red tape and improve transparency. Here’s a summary:
- UnitedHealthcare, UnitedHealth’s insurance unit, said more than 70% of prior authorization requests will be part of this standardized process by the end of the year.
- The process will apply across its commercial plans, government-backed Medicare Advantage and Medicaid businesses, the insurer said.
- CVS Health said its Aetna insurance unit has standardized 88% of its prior authorization volume.
- The standardized approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services, including CT scans and MRIs, industry group AHIP said.
- UnitedHealthcare said it aims to improve predictability, reduce rework and decrease the number of requests for additional information by standardizing the information health plans require to support prior authorizations.
- It also plans to expand the program to additional medical services and continue cutting the number of procedures that require prior approval.
- UnitedHealthcare said the changes will not affect coverage rules or the medical reasons used to approve or deny care.
The American Medical Association (AMA) has continued to advocate for change. Visit AMA Advocacy in Action to find out what’s at stake in fixing prior authorization and other advocacy priorities the AMA is actively working on.
Caroline
