ACR urges Anthem to rescind outpatient imaging policies

The American College of Radiology (ACR), along with 11 other national medical specialty societies and patient advocacy groups, is urging Anthem Blue Cross/Blue Shield to eliminate an outpatient imaging policy it put into effect last year.

In August, the insurer announced that it planned to stop automatically paying for hospital-based outpatient CT and MRI exams for its members, shifting instead to what it calls a "medical necessity review" of these exams designed to move studies to freestanding centers. Currently, the policy is in effect in nine states; Anthem plans to implement a similar policy in as many as 13 states as early as March 2018, according to the ACR.

In a January 16 letter to Dr. Craig Samitt, Anthem's executive vice president and chief clinical officer, the ACR group asked Anthem to rescind the policy.

"Failure to rescind [this policy] could jeopardize patient care and ... undermine a relationship between Anthem and a broad array of the physicians who treat your beneficiaries," the letter warned.

In a related development, in Virginia on January 17, Delegate Patrick Hope (D-District 47) submitted legislation to the state's House of Delegates that would bar Anthem from implementing this type of outpatient imaging policy in Virginia, the ACR said.

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