March 01, 2018

ACR, ACEP and AHA Tell Anthem to Drop ED and Imaging Policies

In a Feb. 26 joint letter to Anthem, Inc., the American College of Radiology (ACR), American College of Emergency Physicians (ACEP), and American Hospital Association (AHA) urged Anthem to rescind its coverage policies for emergency care and outpatient imaging.

The societies stressed that the nation’s largest Blue Cross Blue Shield plan may be placing patients in medical and financial risk:

“The changes to the policy announced by Anthem last week do not address the underlying problem of putting patients in the potentially dangerous position of having to decide whether their symptoms are a medical emergency before they seek emergency care, or risk paying the entire bill if it is not. Only full rescission of the policy will ensure the safety of our patients and your enrollees.”

The groups stressed that the outpatient imaging policy greatly restricts ready access to advanced imaging and disrupts the doctor-patient relationship:
“This policy could negatively impact the safety and quality of care for patients by undermining the coordination of care entrusted to the patient’s treating physician.”

The medical associations urged the insurer to work with the medical community to make care better – rather than taking unilateral actions that are not helpful.

“We ask that Anthem rescind these policies and work with us to design programs to educate patients about the appropriate use of health care services and improve the coordination of care among providers, while increasing transparency requirements surrounding patient out-of-pocket cost responsibility.”

Click here to read the ACR-ACEP-AHA joint letter to Anthem.