Ophthalmologists want Aetna's 'excessive' prior authorization policy rescinded

The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery are asking Congress to urge Aetna to rescind its prior authorization requirements for cataract surgery. 

The Aetna policy began requiring prior authorization for all cataract surgeries, regardless of patient background, on July 1.

"Cataract surgery is vital to restoring patients’ vision and independence," the organizations said in a July 29 letter. "Aetna’s new requirement will cause a large barrier in access to care for

patients who may have already been waiting a substantial amount of time to receive care."

Aetna has provided "no plausible reason" for creating the policy, the organizations said. They also cited reports of the policy already delaying patient access to necessary cataract surgery. 

The Academy and ASCRS, which represent 20,000 medical doctors in the U.S., also are asking Congress to co-sponsor the Improving Seniors’ Timely Access to Care Act, bipartisan legislation that aims to improve the prior authorization process in the Medicare Advantage Program.

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