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May 8, 2023: MGMA and 171 other stakeholders urge UHC to not implement its new GI endoscopy prior authorization program

Advocacy Letter - May 10, 2023

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Medicare Payment Policies

Sir Andrew Witty
Chief Executive Officer
UnitedHealth Group
9900 Bren Rd E
Minnetonka, MN 55343
andrew.witty@uhg.com

May 8, 2023

Dear Sir Andrew,

The undersigned organizations urge you not to implement United Healthcare’s (UHC) gastrointestinal (GI) endoscopy prior authorization program. It is flawed and misguided and will harm patients, limit access to care for vulnerable populations, delay diagnosis of colorectal cancer in younger populations, and needlessly increase physician and practice burden. Nearly 1,500 patients and their physicians have sent letters to UHC expressing the harms, both immediate and long term, that the program will cause.

Impact to patients

The National Cancer Institute confirms that “Colorectal cancer is a leading cause of cancer death among people under 50 in the United States, with rates of new diagnoses still climbing in this age group.” However, UHC’s prior authorization program for GI endoscopy, even though it purportedly excludes screening colonoscopy, will most certainly have a chilling effect on patients’ willingness to undergo medically recommended subsequent colonoscopy examinations after polyps or cancers are removed or for diagnostic testing when they have red flag symptoms. Eighty percent of physicians report that the prior authorization process can lead to treatment abandonment. This policy will also likely exacerbate existing sociodemographic disparities in care and outcomes, as our most vulnerable patients are most subject to access issues.

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