This modification, managed by Home & Community (formerly naviHealth), aims to reduce administrative burdens and improve access to care, reflecting UHC’s broader initiative to decrease prior authorization volume by 10%. However, providers must continue adhering to CMS guidelines for home health services, and specific conditions apply to D-SNP plans in Florida and Tennessee.
Prior authorization requirements can be cumbersome, delaying or even preventing care in some cases. Patients who need prior authorization to get he care they need also generally have form after form to fill out or to have completed by their PCP or hospital physician, who doesn’t have time for adequate visits, much less more paperwork.
As part of their ongoing efforts to reduce prior authorization volume by 10%, UnitedHealthcare has just announced a change in their home health services requirements.
Limits on Where Changes Apply
Beginning April 1, 2025, UHC will no longer require prior authorization or concurrent reviews for home health services managed by Home & Community (formerly naviHealth). This is the next step in an ongoing effort to modernize the authorization process and simplify health care for its members and providers.
Rowan, K. (2025, March 7). Prior authorization requirement removed by UnitedHealthCare. The Rowan Report. https://www.therowanreport.com/2025/03/07/prior-authorization-requirement-removed-by-unitedhealthcare/
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