UnitedHealthcare’s Controversial Prior Authorization Policy Withdrawn Amid Widespread Criticism

UnitedHealthcare (UHC), the biggest health plan provider in the United States, abruptly withdrew a highly controversial policy that would have required prior authorization for colonoscopies. The policy, which drew considerable backlash from healthcare professionals and associations, will be replaced with an alternative advance notification process. This proposed replacement will require physicians to gather and submit patient data prior to performing non-screening and nonemergent colonoscopies, a move seen as adding undue burden to an already complex procedure.

UHC’s Attempt at Policy Redirection Raises Further Concerns

The American Gastroenterological Association (AGA), a notable critic of UHC’s actions, has lambasted the company’s handling of the policy changes. Barbara H. Jung, M.D., president of the AGA, faulted UHC for their ‘slap-dash’ approach and voiced concerns that UHC lacks convincing data demonstrating significant overutilization of endoscopy and colonoscopy procedures, which could have been used to justify such a drastic policy alteration. She further highlighted the potential repercussions for patient access to these crucial, often life-saving, medical procedures.

A Misguided Advance Notification Process

UHC’s new plan is seen as a thinly veiled attempt to offload administrative responsibilities onto physicians, rather than dealing with the fundamental issues at hand. Physicians now face an even greater administrative burden, complicating their already intricate roles, without providing immediate patient care benefits. The AGA, backed by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology, argued vociferously against the original prior authorization policy, claiming that it posed substantial risks to patients.

Future Implications: A Potential Threat to Patient Care

UHC’s new direction suggests a potential future where data collection takes precedence over patient care, raising alarm bells within the medical community. The AGA calls on members to share their stories about how this policy would affect their practices and patients, emphasizing that UHC’s misguided program involves a complex administrative process that will ultimately impact millions of Americans who require colonoscopies or endoscopies.

It remains clear that UHC’s decisions and actions in this matter are not only out of touch with the needs of healthcare providers but also potentially jeopardize patient care.

Source Article: https://www.fiercehealthcare.com/payers/unitedhealthcare-nixes-prior-authorization-rule-docs-arent-happy-about-whats-replaced-it