2026年5月5日 / 美国东部时间上午10:51 / 哥伦比亚广播公司新闻
联合健康保险周二表示，将取消此前30%需要保险公司审批的医疗服务的“预先审批”要求，这一政策转变有望减少繁文缛节，加快患者获得护理的速度。
此举正值医保行业面临限制预先审批的压力之际。预先审批是指医生或医院等医疗服务提供者需要获得患者保险公司的批准，才能提供护理服务的流程。
长期以来，预先审批因耗费医生办公室的时间、阻碍患者获得护理而饱受批评。美国医学协会发现，这类办公室平均每周要花费12小时为医疗治疗申请保险公司审批。
批评人士称，这些时间本可以更好地用于提供医疗服务，而一些患者则报告称自己被保险公司拒绝治疗。
美国最大的健康保险公司联合健康保险在一份声明中表示，其保单覆盖的医疗服务中，有2%需要预先审批。该公司称，其中约92%的审批会在24小时内完成。
“预先审批是一项必要的保障措施，但仅应在真正能够保护患者、改善护理质量时使用，”联合健康保险首席执行官蒂姆·诺埃尔在一份声明中说道。“取消这些要求是我们为让患者能够在需要时更轻松地获得所需护理，并确保医生能够花更多时间陪伴患者而采取的又一项举措。”
联合健康前首席执行官布莱恩·汤姆森于2024年12月被枪杀。这起枪击案的嫌疑人路易吉·曼吉奥内目前正在联邦和州法院等待审判。
哪些治疗将不再需要预先审批？
联合健康保险表示，以下医疗服务将不再需要预先审批：
- 部分门诊手术
- 部分诊断检查，例如超声心动图
- 部分门诊治疗
- 部分脊椎按摩护理
该公司在声明中表示，将在新规生效前在UHCProvider.com网站上公布完整的服务清单。
新规何时生效？
联合健康保险表示，将在2026年底前实施这些变更。
其他健康保险公司是否也在减少预先审批要求？
去年，由健康保险行业贸易协会美国健康保险计划（AHIP）代表的一批保险公司表示，其部分大型会员企业将采取措施简化预先审批流程。
这些公司包括多家蓝十字蓝盾保险公司，例如加利福尼亚蓝十字蓝盾，以及哈门那、凯撒医疗集团和联合健康保险等大型保险公司。
UnitedHealthcare to cut prior authorization for 30% of services. Here’s what to know.
May 5, 2026 / 10:51 AM EDT / CBS News
UnitedHealthcare said on Tuesday it is eliminating “prior authorization” requirements for 30% of medical services that previously required insurer approval, a policy shift that could eliminate red tape and speed access to patient care.
The move comes amid pressure on the health insurance industry to limit prior authorizations, the process by which health care providers such as doctors or hospitals obtain approval from patients’ insurance carriers to deliver care.
Prior authorizations have long drawn criticism for the time they require of physicians’ offices and for hindering patients’ access to care, with the American Medical Association finding that such offices spend an average of 12 hours per week seeking insurer approval for medical treatments.
Critics say those hours would be better spent providing medical care, while some patients report being denied treatment by their insurance companies.
UnitedHealthcare, the largest U.S. health insurer, said in a statement that prior authorization is required for 2% of the medical services covered under its policies. About 92% of those are approved within 24 hours, the company said.
“Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care,” UnitedHealthcare CEO Tim Noel said in a statement. “Eliminating these requirements is one more way we are working to make it easier for patients to get the care they need when they need it and ensure doctors can spend more time with their patients.”
Former UnitedHealth CEO Brian Thomson was shot and killed in December 2024. The suspect in the shooting, Luigi Mangione, is awaiting trial in both federal and state court.
Which treatments will no longer require prior authorizations?
UnitedHealthcare said the following procedures will no longer require prior authorization:
- Select outpatient surgeries
- Some diagnostic tests, such as echocardiograms
- Some outpatient therapies
- Some chiropractic care
In its statement, the company said it would post the full list of services at UHCProvider.com before the changes take effect.
When does this take effect?
UnitedHealthcare said it will implement the changes by the end of 2026.
Are other health insurers reducing prior authorizations?
Last year, a group of insurers represented by Health Insurance Plans (AHIP), a trade association for the health insurance industry, said some of its biggest members would take steps to streamline prior authorization.
They include many Blue Cross Blue Shield insurers, such as Blue Cross Blue Shield of California, as well as large insurers such as Humana, Kaiser Permanente and UnitedHealthcare.
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