On May 31, UnitedHealthcare reversed the proposed June 1 implementation of a controversial prior authorization process that would require gastroenterologists to submit requests for certain endoscopy procedures.
Instead, it implemented an advanced notification process that requires practices to submit certain patient data leading up to procedures. Practices that follow directives will have the opportunity to join a UHC “gold card” program in 2024.
Three major gastroenterological societies — the American College of Gastroenterology, the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy — have opposed UHC’s prior authorization plans since they were released in March and were disappointed about the lack of communication from UHC.
Last week, UHC gave the major societies less than 24 hours of notice to discuss the alternative advanced notification process, asking for public support from the societies.
Lawrence Kim, MD, vice president of the AGA and gastroenterologist at South Denver Gastroenterology in Littleton, Colo., spoke with Becker’s about the new advanced notification process and the difficulty of working with UHC throughout the proposed reform.