New APTA Practice Advisory: Commercial Insurance Out-of-Network Repricing Alert
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Outpatient services for many Medicare Advantage patients are impacted, but UHC's Gold Card program could provide some relief.
(This article was updated on Dec. 4 from its initial publication on Aug. 19 to include additional clarifications and guidance from UHC.)
In disappointing moves that walk back needed reforms to burdensome prior authorization policies announced in August 2023, UnitedHealthcare has expanded prior authorization requirements within certain plans for follow-up PT visits when services are provided in office and outpatient hospital settings, effective Sept. 1.
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