Tuesday, May 16, 2023

United Healthcare: STAT says Colonoscopy restrictions are "Stunning"

There's a very long article at STAT but I think it's open access, about major proposed or imminent changes in colonoscopy coverage at United Healthcare.


Apparently it's not brand new, but new to me today.  See also Fierce Healthcare,


Here's a quote:  In May, the American College of Gastroenterology drafted a letter, alongside the other gastroenterology societies, to UnitedHealthcare pleading once more for them to cancel the policy. A total of 175 different professional and medical organizations signed on. But they’re not confident their appeal will change anything. The sense they’ve gotten from their meetings with United is that the policy is “not negotiable,” Early said.

Here's some catch-up, also from STAT's article.

When gastroenterologists learned in March that UnitedHealthcare plans to barricade many colonoscopies behind a controversial and complicated process known as prior authorization, their emotions cycled rapidly between fear, shock, and outrage.

The change, which the health insurer will implement on June 1, means that any United member seeking surveillance and diagnostic colonoscopies to detect cancer will first need approval from United — or else have to pay out of pocket.

A multi-stakeholder complaint letter to UHC is here.


I asked GPT4 to review the associations' letter, critique it, list potential improvements, and then rewrite it.    Here.