UnitedHealthcare’s attempt to clarify its ill-advised advance notification program doesn’t change the fact that this replacement policy will delay care and limit access to life-saving colonoscopy and other endoscopic examinations that prevent cancer.
At first, UnitedHealthcare claimed its prior authorization policy would address overutilization of services, but it is now justifying advance notification as an opportunity to identify areas where underutilization may be present. This about-face by UnitedHealthcare is merely an attempt to divert attention from the barriers they are erecting to appropriate care recommended by gastroenterologists in accordance with clinical guidelines. Despite requests for UnitedHealthcare to provide evidence to justify these policy changes, the medical community has received essentially none.
Erecting any type of barrier to life-saving procedures is irresponsible, especially when studies show that adherence to follow-up surveillance colonoscopies after polyp removal is especially low. Our goal should be to increase adherence for follow-up surveillance colonoscopies after polyps have been found, but we know from experience that requiring advance notification – a pretext for future prior authorization requirements – for these procedures will do the opposite. UnitedHealthcare knows full well that a small but significant percentage of patients required to go through this process will give up, thus forgoing important, and even lifesaving, procedures.
UnitedHealthcare should choose patient care over paperwork and rescind this misguided policy immediately.
DHPA will continue to work with our fellow gastroenterology societies, physician and patient advocacy groups, state and federal policymakers, and the broader health care community to oppose any policies that limit patient access to life-saving colonoscopy and other endoscopic procedures that prevent cancer.