05/11/2023

‘Stunning’ Change to United’s Colonoscopy Coverage Roils Physicians and Patients

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.

“It was stunning,” said Dayna Early, a gastroenterologist at Washington University in St. Louis and chair of the American College of Gastroenterology’s board of governors. “It applies to everything we do except screening colonoscopy” — routine procedures meant to detect cancer in low-risk, healthy members of the general population between the ages of 45 and 74. “One of the most frustrating things is we don’t understand why they are doing this.”

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