August 29, 2025
Beginning in 2023, UnitedHealthcare (UHC) eliminated over 700 of their prior authorizations through code reductions and a Gold Card program. Both reforms applied to most UnitedHealthcare members for commercial, Medicare Advantage, and Medicaid. They also came in part through the advocacy of the NCAFP.
“Prior authorizations help ensure member safety and lower the total cost of care, but we understand they can be a pain point for providers and members,” said UHC Chief Medical Officer Dr. Anne Docimo in a 2023 statement. “We need to continue to make sure the system works better for everyone, and we will continue to evaluate prior authorization codes and look for opportunities to limit or remove them while improving our systems and infrastructure.”
The entire list of prior authorizations that UHC eliminated in these changes includes a number of imaging prior authorizations that family physicians have had to routinely receive prior authorization for before they can refer to a radiologist.
In addition, the UHC Gold Card program launched on Oct. 1, 2024. The program reduced prior authorization requests across over 500 UHC codes. Here’s how: the program assigns eligibility by tax identification number (TIN) for provider care groups, including a hospital system, a group of practices under one tax ID (like a CIN), or an individual practice. Eligible TINs won’t need to apply. Instead, they are eligible by:
This program covers nearly 500 different codes for eligible practices. In addition, it supplements the previous elimination of prior authorization for 200 codes. UHC is the only national health insurer to make these broad improvements.
Both the NCAFP and the American Academy of Family Physicians (AAFP) have been advocating for reduction programs like this one at both the state and federal levels. While our work for your improved administrative workload is not done, these changes are a significant step forward. The NCAFP continues to advocate for similar reforms with major insurance payers in North Carolina.
The North Carolina Academy of Family Physicians, Inc. (NCAFP) is a nonprofit professional association headquartered in Raleigh which represents over 4,300 family physicians, family medicine residents, and medical students across the state. It is the largest medical specialty association in North Carolina and is a constituent chapter of the American Academy of Family Physicians, based in Leadwood, KS.
