The American College of Radiology (ACR), along with 11 other national medical specialty societies and patient advocacy groups, is urging Anthem Blue Cross/Blue Shield to eliminate an outpatient imaging policy it put into effect last year.
In August, the insurer announced that it planned to stop automatically paying for hospital-based outpatient CT and MRI exams for its members, shifting instead to what it calls a "medical necessity review" of these exams designed to move studies to freestanding centers. Currently, the policy is in effect in nine states; Anthem plans to implement a similar policy in as many as 13 states as early as March 2018, according to the ACR.
In a January 16 letter to Dr. Craig Samitt, Anthem's executive vice president and chief clinical officer, the ACR group asked Anthem to rescind the policy.
"Failure to rescind [this policy] could jeopardize patient care and ... undermine a relationship between Anthem and a broad array of the physicians who treat your beneficiaries," the letter warned.
In a related development, in Virginia on January 17, Delegate Patrick Hope (D-District 47) submitted legislation to the state's House of Delegates that would bar Anthem from implementing this type of outpatient imaging policy in Virginia, the ACR said.
