NEW YORK (AP) - UnitedHealth is tightening its coverage rules on hysterectomies.

NEW YORK (AP) UnitedHealth is tightening its coverage rules on hysterectomies.

The largest U.S. health insurer will require health care professionals and facilities and providers to notify it in advance if they plan to perform some types of hysterectomies. UnitedHealth said it won't approve the procedure if it concludes that the operation isn't medically necessary.

UnitedHealth Group Inc. says the changes are based on recommendations from the American Congress of Obstetricians and Gynecologists, which says vaginal hysterectomies are recommended over abdominal procedures and "keyhole" laparoscopic procedures because they are associated with better outcomes and fewer complications.

The Minneapolis company said the guidelines will take effect April 6. Vaginal hysterectomies performed on an outpatient basis won't have to be approved ahead of time.