Despite Last Minute Change, UnitedHealthcare's Policy for Virtually All Colonoscopies and Endoscopies Lays Groundwork for Delays, Disruptions, and Denials of Life-saving Services
WASHINGTON, June 1, 2023 /PRNewswire/ -- While the American Gastroenterological Association (AGA) accepts that UnitedHealthcare (UHC) backed off its disastrous decision to begin imposing prior authorization on gastroenterology endoscopy services for all commercial plans starting June 1, AGA remains extremely concerned that the advance notification program UHC is rolling out instead is a temporary patch likely to have significant repercussions for patient access in the coming months. UHC's advance notification program, hastily announced to reporters late yesterday, only temporarily postpones prior authorization requirements set to impact the insurance giant's 27 million commercial beneficiaries while increasing the administrative burden on providers. Clear to the AGA from discussions last Friday, UHC does not currently have data demonstrating any significant overutilization of critical endoscopy and colonoscopy procedures that would justify this program or prior authorization. Since colorectal cancer is the #2 cancer killer and rates are rising in younger adults, now is not the time to increase barriers for patients who need GI care.
- The nebulous advance notification program UHC announced late last night will impact virtually all endoscopies and colonoscopies for UHC's commercial plans.
- The poorly defined "advance notification program" would ostensibly require physician practices to input copious amounts of highly complex and granular patient data prior to performing colonoscopies and endoscopies.
- These services are critical for the early diagnosis of life-threatening diseases such as colorectal cancer and for monitoring patients' disease progression.
- This new policy comes despite immense pressure from physicians, patients, lawmakers, and regulators to crack down on abusive prior authorization policies.