After outcry, UnitedHealthcare softens prior authorization policy for colonoscopies
An insurer backs off from new barriers to colonoscopies, but imposes new incentives to share data justifying the procedures.
After weeks of protest from physician organizations and patients, UnitedHealthcare has put a controversial new prior authorization policy for gastroenterology procedures on hold. The policy, which requires physicians and patients to get approval from the insurance giant for nearly all gastroenterology procedures, including diagnostic and surveillance colonoscopy, or potentially face paying out of pocket, would have gone into effect on June 1.
Instead, the company is adopting a different policy that it calls “advanced notification,” requiring physicians to let United know they’ll be performing certain gastrointestinal procedures and provide information such as why it’s needed and the patient’s medical history. “This Advance Notification will not result in the denial of care for clinical reasons or for failure to notify,” a UnitedHealthcare spokesperson told STAT in an email.
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