Florida insurer requires preauthorization for digital mammo

Florida Today is reporting that Brevard County's largest healthcare insurer, Health First Health Plans, is requiring women who want digital mammograms for breast cancer screening to first receive authorization from the company.

The newspaper quotes Shawn Farley, spokesman for the American College of Radiology (ACR), as saying the organization is "unaware of any other payor in any part of the country that is requiring preauthorization for digital mammography." He added that the ACR is looking into the insurer's policy.

The publication also cites Health First Health Plans' vice president and medical director Dr. Joseph Collins as saying the payment policy is based on a 2005 federal study that concluded digital mammography benefits women less than 50 years of age, premenopausal women, or women of any age with dense breast tissues.

He is quoted as saying the insurer believes it is "reasonable for us to require preauthorization -- to limit this technology to the age groups where there is clear benefit."

He said the policy, which has drawn the ire of at least one women's radiology center in Orlando, has rejected one or two elderly women to date.

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