April 11, 2019

ACR and UHC Discuss Hospital Outpatient Site of Service Policies

Representatives of the American College of Radiology (ACR) Commission on Economics and Payer Relations Committee held a conference call with UnitedHealthcare (UHC) executives April 5th to discuss the insurer’s imaging site of care preauthorization policy.

The ACR’s representatives asked questions and raised some concerns about potential negative impacts of the policy for patients. UHC representatives listened to the concerns and agreed to look into making some changes to the guideline to ensure timely patient access to quality imaging services.

The ACR will continue to have regular discussions with UHC regarding this guideline and other policies impacting imaging.

Separately, UHC recently raised the age exemption for prior authorization applicable to pediatric patients under age 19 for certain advanced computed tomography (CT), magnetic resonance (MR) and magnetic resonance angiography (MRA) outpatient imaging procedures.

The guideline, which became effective March 1, 2019, applies to UHC commercial plans in all states except Alaska, Connecticut, Iowa, Kentucky, Maine, Utah, Vermont and Wisconsin.