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.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.