UnitedHealthcare closes in on controversial GI care changes: 5 things to know

Despite protests from patients, health systems and providers, UnitedHealthcare is moving forward with major changes to its prior authorization requirements for gastroenterology care, which will take effect June 1. 

The changes were first proposed at the beginning of March and have faced strong opposition from several providers. 

Here are five things to know about upcoming GI care changes: 

1. UnitedHealthcare plans to cut back on its overall use of prior authorization, removing procedures and devices from the list and reducing yearly authorizations from 13 million to 10 million. It has not specified which services will be affected. 

2. Beginning June 1, GI patients will need prior authorization for gastroenterology endoscopy services, including esophagogastroduodenoscopies, capsule endoscopies, diagnostic colonoscopies and surveillance colonoscopies. 

3. On June 1, UnitedHealthcare will also change its telehealth reimbursement policies for individual and family plans. 

4. GI industry groups, including the American College of Gastroenterology, have released opposition plans to the changes. 

5. A 2022 study from the American Medical Association showed that excessive prior authorization puts patients at higher risk for hospitalization, life-threatening events and permanent bodily damage. 

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