UnitedHealthcare halted its controversial prior authorization policy for gastroenterology endoscopy services, set to start on June 1, opting instead to move forward with an advanced notification program. Following widespread backlash from more than 4,500 gastroenterologists and patients, the insurance company announced it would postpone the prior authorization policy that would have affected more than 27 million of its beneficiaries. Instead, UnitedHealthcare plans to implement an advance notification process “for non-screening gastroenterology procedures” under its commercial plans.
Author: Abhay Panchal
AGA’s new Clinical Practice Update provides guidance for the diagnosis and management of extraesophageal gastroesophageal reflux disease (GERD). The guidance and associated clinical decision support tool focus on conditions suspected to have potential relationships to acid reflux and provide best approaches to diagnosis, evaluation and therapy.
A deeper understanding of the mechanisms underlying the success of fecal microbiota transplantation (FMT) is needed to further improve its effectiveness, according to two recent reviews published in Cell Host and Microbe. Both research teams agree that more needs to be known about how various underexplored factors ― such as the patient’s diet and genetic background, how closely the donor’s microbial composition matches the patient’s existing microbiome, and the presence of nonbacterial gut inhabitants like viruses and fungi ― affect FMT success, according to a press release.
New York City-based NewYork-Presbyterian was named in a civil lawsuit that alleges Zhi Alan Cheng, MD, a gastroenterologist who previously practiced at the health system’s Flushing, N.Y., location, drugged and sexually assaulted a patient. Dr. Cheng was employed by NewYork-Presbyterian between July 2020 and December 2022. According to a complaint filed June 7, a 19-year-old woman was admitted to the emergency room with gallstone-induced abdominal pain. On June 21, 2021, two days after she was admitted, Dr. Cheng allegedly examined the victim without other staff present, performing an invasive and unnecessary rectal examination under the guise of medical treatment, according…
With 2023 poised to be the year of the adalimumab (Humira, AbbVie) biosimilar wave, a new report focuses on market expansion and sustainability for biosimilars in the United States. According to the report, issued by Cardinal Health, gastroenterologists appeared to be comfortable with the prospect of prescribing a Humira biosimilar, with 93% saying they were at least somewhat comfortable and 50% very comfortable. Safety and efficacy as well as overall issues with switching were the most often cited concerns. The first adalimumab biosimilar, adalimumab-atto (Amjevita, Amgen), entered the U.S. market on Jan. 31, after six years of regulatory delay. At…
The controversial prior authorization policy for colonoscopies that UnitedHealthcare wanted to put into effect today will not take place, the company said last night in a statement. Instead UHC wants to implement an alternative advance notification process that would require physicians to collect and submit patient data before performing non-screening and nonemergent colonoscopies, capsule endoscopis and esophagogastroduodenoscopies. That doesn’t settle the matter and in fact could be interpreted as being more ominous to patients and the physicians who perform colonoscopies, Barbara H. Jung, M.D., the president of the American Gastroenterological Association (AGA), said in a statement last night.
As I leave a conference organized for a group of physician entrepreneurs, I have so many thoughts running through my head. Some of these thoughts revolve around making my small, fledgling medical practice run more smoothly, reaching more people (and serving them better), and always remembering my why. These are the “business mastermind” skills I signed up to learn at the conference. But I may have come out of this with something way more valuable in the long run. I was also reminded of why I left what I was doing before and why I am continuing to follow this…
In 1988, President Ronal Reagan declared May National Digestive Diseases Awareness Month, and since then activities and programs have been implemented to increase the understanding of causes and treatments for various digestive diseases. The World Gastroenterology Organization celebrates World Digestive Health Day on May 29. The focus of this year’s campaign is “Your Digestive Health: A Healthy Gut from the Start,” which highlights that the gastrointestinal tract promotes organ function from the time of birth through the rest of our lives. The campaign seeks to help individuals better understand the GI tract’s normal function, importance of diet and when to…
Key takeaways: Most medical practices subject to data security regulations of the HIPAA Security Rule have adopted administrative, physical and technical safeguards for electronic protected health information in accordance with the HIPAA Security Rule.