Patients with gastrointestinal (GI) health issues like rectal bleeding and inflammatory bowel disease need timely colonoscopies and endoscopies for individualized treatment plans. However, insurance practices like prior authorization often delay or deny necessary care, leading to adverse health impacts, hospitalizations, and patients abandoning treatment. Insurers prioritize cost over patient health by requiring prior authorization for essential services and medications for GI conditions, despite clinical guidelines. The American Gastroenterological Association recommends establishing independent review boards to ensure evidence-based, patient-centered insurance policies. Gastroenterologists are urging insurers to end overreach into medical decision-making and work with providers to ensure timely care and access to treatments for all patients with GI conditions.
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Insurer “Delay and Deny” Practices Continue to Threaten Patients’ Timely Access to Gastrointestinal Care – It’s Time for Reform
