Ep. 51 - Prior authorizations on colonoscopies?

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UnitedHealthcare changes its policy and the HELP Committee passes PBM reforms

Matthew Handley

and

Ron Howrigon

May 17, 2023

stack of books on table — Photo by Wesley Tingey on Unsplash

This week on the FLATLINING Podcast, Matthew and Ron discuss a new policy from UnitedHealthcare (UNH 0.00%↑) that requires diagnostic and surveillance colonoscopies to undergo prior authorization. At the same time UnitedHealthcare claims they are cutting twenty percent of prior authorizations across the board.

Then, the Senate Health, Education, Labor, and Pensions Committee passed several new regulations on Pharmacy Benefits Managers, including a prohibition on price spreading. Matthew and Ron discuss that and its impacts on patients.

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Articles mentioned in this program:

‘Stunning’ change to United’s colonoscopy coverage roils physicians and patients - STAT News

Easing the prior authorization journey - UnitedHealthcare

Senate panel advances drug pricing bills, including PBM reforms - The Hill

Pfizer CEO calls US drug price plan 'negotiation with a gun to your head' - Reuters

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