Business
Minn. insurers eyeing scans
NEWS IN BRIEF — Posted Jan. 22, 2007
Insurers in Minnesota are joining others across the nation in saying they are going to put more scrutiny on doctors' ordering of computed tomography scans, magnetic resonance imaging and other high-tech scanning procedures.
Three major insurers in the state said this year they will require physicians to get approval from a third-party evaluator before performing such tests.
Medica already is requiring physicians to do so, starting its plan with the new year. HealthPartners says it will institute such a requirement in February. Blue Cross Blue Shield of Minnesota said its requirement will begin in July.
Those plans are among a growing number nationwide seeking to use third-party evaluators as a way, they say, to reduce unnecessary tests and keep imaging costs down. Each Minnesota plan expects annual savings in the millions of dollars.
Physicians would not be paid if they do not get authorization for a procedure.
However, at least with Medica and Health Partners, the plans say doctors still get the final word. The plans would still reimburse for an imaging procedure even if the doctor chooses to discard the third-party evaluator's recommendation.
Medica told the Star-Tribune newspaper in Minneapolis that during a trial procedure of its new policy, physicians changed their orders to less-expensive scans about 10% to 15% of the time.
The Minnesota Medical Assn. has spoken out against these programs, saying they add an unnecessary burden for physicians.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/01/22/bibf0122.htm.
