Insurers Demand Prior Authorization For Colonoscopies
UnitedHealthcare requiring prior authorization will make it more difficult for patients to get endoscopic procedures. Cancer diagnostics and surveillance make up roughly half of the colonoscopies that gastroenterologists perform. In other health industry news, workers at five HCA Healthcare facilities in California have authorized a strike, and more hospitals are adding private police forces.
Stat:
United Colonoscopy Coverage Change 'May Cost Lives,' Doctors Say
When gastroenterologists learned in March that UnitedHealthcare plans to barricade many colonoscopies behind a controversial and complicated process known as prior authorization, their emotions cycled rapidly between fear, shock, and outrage. The change, which the health insurer will implement on June 1, means that any United member seeking surveillance and diagnostic colonoscopies to detect cancer will first need approval from United — or else have to pay out of pocket. (Chen, 5/15)
In other disputes —
Stat:
UnitedHealth Tussle With Arizona Hospital Centers On Care Denials
UnitedHealthcare and Phoenix Children’s Hospital are embroiled in a bitter contract dispute that would lock out families and children from care at the hospital by June if the two sides don’t come to a new agreement. And at least according to the hospital, the fight isn’t over prices, which is the traditional sticking point. (Herman, 5/15)
KFF Health News:
ER Doctors Vow To Pursue Case Against Envision Even In Bankruptcy
If Envision Healthcare files for bankruptcy, a group of emergency room doctors would seek permission to continue their federal lawsuit that claims the private equity-backed company is violating California’s ban on corporate control of medical practices. “I anticipate that we would ask the bankruptcy judge to let our case proceed,” said David Millstein, an attorney representing the Milwaukee-based American Academy of Emergency Medicine Physician Group. “Among other things, Envision’s practices violate the law, are continuing, and need to be addressed.” Still, the future of the lawsuit is uncertain since it’s unclear how a judge might rule. (Wolfson, 5/12)
In hospital updates —
Modern Healthcare:
SEIU Workers At 5 California HCA Hospitals Vote To Strike
Workers at five HCA Healthcare facilities in California have voted to authorize a five-day strike as the two sides continue contract negotiations. The strike, set to start May 22, would involve around 3,000 SEIU-UHW members working at HCA’s Good Samaritan Hospital and its Regional Medical Center in San Jose; Los Robles Medical Center in Thousand Oaks; West Hills Hospital in West Hills; and Riverside Community Hospital in Riverside. (Devereaux, 5/12)
KFF Health News:
As More Hospitals Create Police Forces, Critics Warn Of Pitfalls
When Destiny heard screams, she raced to a hospital room where she saw a patient assaulting a care technician. As a charge nurse at Northeast Georgia Health System, she was trained to de-escalate violent situations. But that day in spring 2021, as Destiny intervened, for several minutes the patient punched, kicked, and bit her. And by the time a team of security guards and other nurses could free her, the patient had ripped out chunks of Destiny’s hair. (Rayasam, 5/15)
Bangor Daily News:
Staff Criticize Closure Of Fort Kent Hospital’s Maternity Ward
The impending closure of the obstetrics unit at Maine’s northernmost hospital could be disastrous for patients who will have to seek care elsewhere, according to current and former staff members. Northern Maine Medical Center in Fort Kent announced this week that it will close its obstetrics unit on May 26. The nonprofit hospital cited a decline in maternity patients and a lack of physicians to maintain services. (Potila, 5/14)
Anchorage Daily News:
Alaska Regional Hospital Proposes $18M Freestanding Emergency Department In South Anchorage
Alaska Regional Hospital has applied with the state for approval to build an $18 million freestanding emergency department in South Anchorage by the end of next year. It’s not the first time the hospital has applied to build a satellite emergency facility in Anchorage, which would be the first of its kind in Alaska. (DeMarban, 5/14)
In news about health care workers —
Politico:
How A Green Card Freeze Will Exacerbate The Nursing Crisis
The stream of international nurses coming to work in the United States could soon slow to a trickle because of a backlog of green card petitions at the State Department. The department announced in its May bulletin it moved the cut-off date for visa eligibility to June 1, 2022 — meaning only those who filed petitions before that date will be able to continue with their applications this fiscal year — because of soaring demand. Anyone who filed a green card petition in the past year, which could include thousands of nurses, won’t be able to proceed with their applications. (Hooper, 5/14)
USA Today:
Women, Minorities Unhappy With Their Doctor's Treatment, Survey Says
When Kira, of Southborough, decided to undergo surgery to remove her fallopian tubes, she encountered a "subtle dismissive" response from her local obstetrician-gynecologist. "I felt like he was listening to me when I said, 'This is why I want the surgery,' but there was a sense that he was humoring me," said Kira, now a master of public health student at Boston University. When she made her surgery request at age 21, the surgeon advised her to "take some time to think about it" and return for consultation after graduation. (Yu, 5/15)
