On May 5, 2026, UHC announced plans to reduce prior authorization requirements by 30%. CEO Tim Noel stated: “Prior authorization is an essential safeguard but should only be used when it truly protects patients and improves care, 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. We are committed to further improving and refining our processes to make reviews quicker, simpler and more efficient.”

UHC also said that, by the end of 2026, it would eliminate an additional 30% of its remaining prior authorization requirements, including those for chiropractic care. The company said a complete list of the affected services would be posted on UHCProvider.com before the changes take effect.

What UHC did not make clear, however, is that these reductions appear to rely on an expansion of the Gold Card Program, which began in 2024. According to UHC guidance published in September 2025, providers must meet the following criteria in each of the two consecutive years in the qualification period:

• Be in network for at least one line of business.
• Submit at least 10 eligible prior authorization requests annually across Gold Card–eligible codes.
• Achieve a prior authorization approval rate of at least 92% in each evaluated year, after appeals, based on eligible prior authorization volume.

In other words, UHC is reducing prior authorization requirements—but only for providers that qualify for its Gold Card Program. According to a UHC contact, the program uses a tiered structure. UHC recently reassigned tiers within its commercial network, a process that is typically completed annually.

The WCA is looking for feedback from UHC providers to determine the impact of these policy changes on patient access in Wisconsin.  All information will be kept strictly confidential.  Reach out to Jacqlyn at: 608-292-1804 or wcahelp@wichiro.org