UHC’s New Prior Authorization Policy is Impacting Care and What You Can Do

October 22, 2024-- Have you or your patients been affected by UHC’s new prior authorization policy?

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Beginning in the fall of 2024, UnitedHealthcare (UHC) announced that it required prior authorization for all physical and occupational therapy, speech-language pathology, and chiropractic services under specified plan products. This began for UHC members covered under Medicare Advantage plans on September 1 and was extended to patients covered by Medicaid managed care plans on October 1. 

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Based on data shared by UHC, it takes an average of four to ten business days to approve these requests. However, providers are reporting extended authorization times and significant technical glitches. While UHC has stated that providers do not need to wait to initiate treatment prior to getting approval from UHC, commencing treatment without authorization places providers at significant financial risk if the services are not approved. 

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The time for advocacy is now!  

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Two professional organizations The American Speech-Language-Hearing Association (ASHA) and the American Physical Therapy Association (APTA) have added advocacy resources to their websites. These resources are accessible to the general public:

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The ASHA Advocacy page includes a patient fact sheet and a fillable form designed to receive feedback about experiences and issues related to UHC’s new policy.

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The APTA Advocacy page includes patient education and provider template letters.

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Providers can also encourage patients experiencing delayed or limited access to care to:

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• Share their stories with their therapists who likely have multiple advocacy channels.
• Call UHC Directly and note reasons for delays or denials of care. Healthcare providers may be able to use this information to submit a request for reconsideration or appeal. 
• Contact 1-800-MEDICARE, and ask a representative to submit their complaint or inquiry to the Medicare Beneficiary Ombudsman (MBO). 
• Contact their Congressional representatives and ask them to support the Improving Seniors’ Timely Access to Care Act (HR 8702/S. 4532), a bipartisan, bicameral legislation that would streamline the prior authorization process under Medicare Advantage (MA) allowing seniors to get the care they need and helping health care providers put patients over paperwork.

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