UHC Finally Listens to ACG and GI Community But Questions Remain
UnitedHealthcare (UHC) announced it will scrap its planned prior authorization restrictions on endoscopy scheduled to start June 1st. Since UHC announced this ill conceived plan in March, curbing this abusive practice has been a top ACG priority.
Late in the evening of May 31st, UHC announced a change of direction and will now implement what it characterizes as an "advance notification program" for GI services effective immediately. Earlier on May 31st, ACG President Daniel Pambianco, MD, FACG, joined patient advocates at a rally organized by the Crohn's and Colitis Foundation at United headquarters in Minnesota, urging UHC to abandon these new prior authorization rules.
"I left yesterday's (Wednesday) patient rally energized and fueled with more passion after speaking and hearing from our patient advocates...We will need this energy too, as this new program only adds to the uncertainty. As you can imagine, this program and announcement raises more questions than answers, and in my opinion, may interfere with the ability to treat patients and practice medicine," said Dr. Pambianco. "For example, I may have to go through a 'comprehensive peer-to-peer discussion' with a UHC representative to educate me on adhering to guidelines as to over- or under-utilization if I choose to not participate. Are they actually going to recommend that I may not be doing enough endoscopies? That's absurd!" added Dr. Pambianco.
Read the full ACG statement here.