Crohn’s & Colitis Foundation Statement on UnitedHealthcare Delaying New Prior Authorization Policy for GI Diagnostic Services

New York, NY – June 2, 2023, UnitedHealthcare (UHC) has delayed implementing a new policy that would have required prior authorization for most physician-prescribed endoscopy and colonoscopy procedures, which was slated to begin June 1. This decision comes after UHC faced significant backlash from the GI community, and a rally was led by the Crohn's & Colitis Foundation alongside IBD healthcare professionals and patients outside UHC’s Minnesota headquarters on May 31. The Foundation was invited to meet with UHC to discuss the policy after the rally.

For inflammatory bowel disease (IBD) patients, which includes Crohn’s disease and ulcerative colitis, GI diagnostic services are critical for monitoring disease progression and early diagnosis of life-threatening diseases such as colorectal cancer. Close to 4,000 people in the Crohn’s & Colitis community have sent letters to UnitedHealthcare's CEO to urge him to stop harmful prior authorization requirements and to prevent further unnecessary delays of care for IBD patients.

Following these patient and professional actions, UHC has instead introduced an Advance Notification Program for non-screening and nonemergent colonoscopies and endoscopies. The program is aimed at preparing for UHC's new "gold card" program scheduled for 2024. Under this planned program, physician practices with a high prior authorization approval rate will be exempt from prior authorization requirements for those services. Full details about the new program have not yet been provided by UHC, and they are still considering implementing prior authorization requirements with the “gold card” program in early 2024.

If implemented, prior authorization will disrupt time-sensitive care for millions and create needless anxiety and delays for patients who may have cancer or other serious gastrointestinal conditions including (IBD).

“While we are pleased that UnitedHealthcare seems to have heard our concerns, this policy still fails to take into account the unique needs of IBD patients,” said Laura Wingate, Executive Vice President, Education, Support & Advocacy, Crohn’s & Colitis Foundation. “We need more details about the advance notification program to better inform our patients and healthcare providers. The Foundation will continue urging UnitedHealthcare to create policies that are in the best interest of patients and will not overburden healthcare professionals.”

About the Crohn’s & Colitis Foundation

The Crohn's & Colitis Foundation is the leading nonprofit organization focused on both research and patient support for inflammatory bowel disease (IBD), with the mission of curing Crohn's disease and ulcerative colitis and improving quality of life for the millions of Americans living with IBD. The Foundation’s work is dramatically accelerating the research process, while also providing extensive educational and support resources for patients and their families, medical professionals, and the public. For more information, visit crohnscolitisfoundation.org, call 888-694-8872, or email  [email protected].

Contact:
Rachel Peifer
[email protected]