January 10, 2019

UHC Delays Site-of-Care Preauthorization Policy

UnitedHealthcare (UHC), one of the nation’s largest private health care insurers, has delayed its new site-of-care prior authorization review policy for certain advanced computed tomography (CT), magnetic resonance (MR) and magnetic resonance angiography (MRA) outpatient imaging procedures until February 1, 2019.

First announced in October 2018, the policy was originally scheduled for implementation on January 1.

The revised rollout date and other policy details are covered on pages 32–33 of the January 2019 UNC Provider Network Bulletin. The insurer indicated the delay will “allow time for additional communication and optimal rollout.”

Site-of-care prior authorization at UHC will apply to its commercial plans including UnitedHealthcare, Neighborhood Health Partnership, and UnitedHealthcare of the River Valley and affiliated providers in all states, except Iowa, Kentucky and Utah.

The policy will branch from its current prior authorization process for medical necessity determination. The insurer will review site-of-care prior authorization for hospital outpatient services based on a new utilization review guideline published in UHC’s October 2018 Medical Policy Update Bulletin.

Please address your questions to Kathryn Keysor, ACR senior director of economics and health policy at kkeysor@acr.org.