Nation's Ophthalmologists Urge Congress to Protect Patients From Health Insurer Policy Disrupting Medically Necessary Care Across the Country
- Wall Street closes rollercoaster week sharply lower
- Invesco (IVZ) Reportedly in Talks to Merge With State Street's (STT) Asset Management Business, Citi Sees More Cons than Pros
- FDA Votes "No" on Pfizer (PFE) Booster for 16+ Age Group, 2 Yes 16 No
- Jefferies Raises Price Targets on Alphabet (GOOGL) and Facebook (FB) as They Are Still Inexpensive Relative to Growth, Reiterates Snap (SNAP) as a Best Growth Idea
- Tesla (TSLA) Could Deliver 900K EV Units This Year and 1.3M in 2022 - Wedbush
Get instant alerts when news breaks on your stocks. Claim your 1-week free trial to StreetInsider Premium here.
SAN FRANCISCO, July 29, 2021 /PRNewswire/ -- Today, the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, representing 20,000 medical doctors in the United States, sent a letter to members of Congress, asking for support in our ongoing effort to rein in excessive prior authorization requirements imposed by insurers. These policies take control of medical decisions from doctors and put them in hands of insurance company administrators who delay and disrupt, and sometimes deny medically necessary care.
The most recent and egregious example of this problem is a new policy implemented by Aetna that requires prior authorization approval for all cataract surgery starting July 1, 2021. The new policy applies equally among its members, from children born with cataracts, to adults whose cataracts interfere with their ability to drive, to people in need of emergency cataract surgery before vision-threatening retinal conditions can be treated.
Cataract surgery is one of the most effective and common procedures performed in all of medicine with some 4 million American choosing to have cataract surgery each year and an overall success rate of 97 percent or higher. And yet Aetna has put this successful, long-established procedure through a new algorithm known only to the insurer and determined that some these surgeries are unnecessary. Aetna has provided the Academy and ASCRS with no plausible reason for creating a policy that no other large healthcare insurer believes necessary.
When prior authorization policies began to take hold about 20 years ago, it was intended to focus on specific new drugs and diagnostic tests. But over the years, the practice has expanded to common procedures and surgeries, ensnarling physicians and patients in red tape, delaying care and putting patient's health in peril. It's not even clear that insurance companies save money in the long run because after all the delays and hassle, most of these surgeries are approved anyway.
A survey by the American Medical Association found that 94 percent of doctors report that their patients have experienced delays in care due to prior authorization. Some 30 percent of doctors say that the prior authorization process has led to a serious adverse event of a patient in their care.
The Academy and ASCRS are asking members of Congress to support our efforts to ensure patients have timely access to sight-restoring care by urging Aetna to rescind their policy. We also urge members of Congress to cosponsor H.R. 3173, the Improving Seniors' Timely Access to Care Act. This bipartisan legislation seeks to improve the prior authorization process in the Medicare Advantage Program by increasing transparency, streamlining processes, and minimizing the use of prior authorization for services that are routinely approved.
View original content to download multimedia:https://www.prnewswire.com/news-releases/nations-ophthalmologists-urge-congress-to-protect-patients-from-health-insurer-policy-disrupting-medically-necessary-care-across-the-country-301344785.html
SOURCE American Academy of Ophthalmology
Serious News for Serious Traders! Try StreetInsider.com Premium Free!
You May Also Be Interested In
- Byondis ESMO Late-Breaking Presentation Confirms ADC [Vic-] Trastuzumab Duocarmazine (SYD985) Superior to Physician's Choice in Pre-treated Locally Advanced or Metastatic HER2-Positive Breast Cancer
- DogeCola On Steroids: Launches Its First GameFi Platform
- The Western China International Fair (WCIF) Holds in Chengdu on September 16-20, 2021
Create E-mail Alert Related CategoriesPRNewswire, Press Releases
Sign up for StreetInsider Free!
Receive full access to all new and archived articles, unlimited portfolio tracking, e-mail alerts, custom newswires and RSS feeds - and more!