ACG Governors Urging State Review of UHC Prior Authorization Rules

From the Chair of ACG Board of Governors, Dayna S. Early, MD, FACG and Vice Chair, Sita Chokahavatia, MD, MACG

In response to UnitedHealthcare's (UHC) recent announcement requiring prior authorization for GI procedures, the ACG Board of Governors is working with your state's insurance commissioners and policymakers, urging a review of the rationale and data supporting these changes, as well as hearings to assess the impact to patient care. We know that ACG members are upset and frustrated. Fortunately, the ACG Board of Governors is structured to be your voice for clinical GI at both the federal and state level. ACG Governors are also engaging patient advocacy groups, state GI societies, and state medical associations in these efforts.

The ACG Governors will also be discussing these important local issues with Congress later this month, as part of the 2023 ACG Advocacy Day.

Protecting the Patient-Provider Relationship: ACG recently met with UHC to express our opposition to these changes, and will meet with UHC again in the coming days to review the clinical literature and "data on over-utilization," as cited in UHC's FAQs document. It's imperative that the clinical data drive any coverage policy. Prior authorization is harming patient care, GI practices, and a key factor in physician-burnout. We have heard from our membership and know how important it is to protect the autonomy of the patient-provider relationship.

The ACG Prior Authorization Task Force has also focused on practical guidance and tools to immediately reduce the burdens of prior authorization, while ACG advocates for comprehensive policy reforms.

Stay tuned for more updates from ACG.