Imaging advocates issue ‘call to action’ over UnitedHealthcare payment policy

Imaging advocates issued a “call to action” on Thursday over a UnitedHealthcare payment policy they worry is infringing on the patient-physician decision-making process.

The nation’s largest commercial insurer recently updated its coverage to provide reimbursement for coronary CT angiography, labeling such imaging as a “first line test” for assessing stable chest pain.

UHC has insisted it is not pushing CCTA over other tests including positron emission tomography or single-photon emission CT, according to the American Society of Nuclear Cardiology. Yet, the Fairfax, Virginia-based said it is hearing reports to the contrary from its membership, with the insurance giant allegedly favoring CCTA over SPECT.

“ASNC is adamant that the choice of tests is within the purview of the physician’s clinical judgment and that such decisions should be made in consultation with the patient,” the group wrote Thursday night, adding that it “advocates for putting the patient—never any specific test—first.”

The nuclear cardiology group is asking the field for immediate input to further understand the matter. It has created a reporting form and wants to hear about such prior authorization roadblocks from radiology benefits managers, encountered when recommending a certain modality for patients.

ASNC also warned physicians about its dispute with UnitedHealthcare back in November.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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