In a strongly worded letter sent to UnitedHealth Group’s CEO on May 8, 2023, 175 state and specialty medical associations and physicians’ groups have opposed United’s new policy requiring prior authorization for most GI endoscopic procedures, including colonoscopies, and urged United not to implement the policy as scheduled on June 1, 2023.
The letter states that the new policy “is flawed and misguided and will harm patients, limit access to care for vulnerable populations, delay diagnosis of colorectal cancer in younger populations, and needlessly increase physician and practice burdens.” The letter points out that colorectal cancer is a leading cause of cancer death among people under 50 in the U.S. and that the policy will “undoubtedly cause delays in care for high-risk individuals.”
Citing survey data, the letter also points out the high burden that the prior authorization requirements place on physician practices, stating: “Implementing yet another program that adds to the already high administrative burden physicians face for procedures that are medically appropriate and indicated, and potentially lifesaving, seems like a waste of UHC’s resources, and, most certainly, physicians’ time.”
United claims that the policy is based on guidelines published by gastroenterology medical societies, but the American Gastroenterological Association, the American College of Gastroenterology, and the American Society for Gastrointestinal Endoscopy all signed the letter and oppose the policy. In a press release, the American Gastroenterological Association stated that it is “profoundly alarmed and disappointed by” the policy and that “UHC’s decision to expand prior authorization policies to include GI endoscopies is the latest example of insurance company overreach – often with terrible consequences for patients.”