May 06, 2021

Physician Community Seeks Changes to UHC Prior Authorization for Radiation Therapy

The American College of Radiology® (ACR®), the American Society for Radiation Oncology and the Association of Community Cancer Centers sent a letter April 28 to United Healthcare (UHC) regarding prior authorization for viable radiation therapy services. The associations believe UHC’s prior authorization tool contains onerous processes that will delay care for cancer patients. As reported previously, prior authorization for certain outpatient radiation therapies now are required for UHC commercial members. The associations have engaged with UHC since the tool’s rollout to ensure meaningful steps are taken to reduce administrative burdens. The letter outlines specific recommendations to improve the prior authorization tool for radiation oncology practices, UHC and the patients these groups serve.

UHC has opted to require prior authorization only for the radiation therapy treatment delivery codes. While we support this approach, additional changes are necessary to reduce administrative burdens and enable UHC to better focus its utilization management resources. UHC has acknowledged receipt of the letter and will closely review our recommendations.

Questions about UHC’s prior authorization process or radiation oncology services should be directed to Alicia Blakey, ACR Senior Economic Policy Analyst.