UnitedHealthcare suspends some prior authorization rules for hospitals


UnitedHealthcare suspended some prior authorization requirements for in-network hospitals and in-network skilled nursing facilities, according to the insurer's webpage on its prior authorization updates during the pandemic.

The provision suspends prior authorization requirements for hospital or practice transfers. The policy may vary by state, depending on regulatory requirements. It also replaces similar temporary prior authorization provisions for SNF admissions, facility transfers and COVID-19-related oxygen requests, unless the similar provisions extend to higher levels of care or expire later than the new suspension does.

The suspension is effective Dec. 18, 2020, through Jan. 31, 2021. The change affects hospitals and SNFs that are in network with UnitedHealthcare's Medicare Advantage, Medicaid, individual and group health plans. 

After Jan. 31, UnitedHealthcare said it may retrospecitvely review certain services that were given during the suspension period. "Admission notification is still required during this time, in alignment with the current protocol to support you in arranging post-admission care or other support services, if needed," the insurer said. 

View the full update here.

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