March 01, 2007

Docs dig deeper to fight insurer review of imaging tests

In a followup story, the Minneapolis Star Tribune reports that "the Minnesota Medical Association on Wednesday asked regulators to pull the plug on Medica's controversial program to curb the use of high-tech diagnostic imaging.

The MMA asserts that HealthHelp, the company hired by Medica to give approval for tests such as MRIs and CT scans, is not licensed in Minnesota to perform "utilization review," as required by state law. ...

Medica began the preapproval process Jan. 2 on a voluntary basis. It becomes mandatory starting today, and Medica will not pay for scans not first submitted for review to HealthHelp, a Texas-based radiology management firm.

Medica, the state's second-largest health insurer, is the first to require reviews, saying the plan will save it $17 million a year. HealthPartners started a review process this month, and Blue Cross and Blue Shield of Minnesota is expected to do so in July.

Doctors say that consulting HealthHelp 'is a waste of energy, time and money,' and increases health care costs."

This cat-fight (or CAT scan-fight, along with MRI- and PET-scan fight) is worth following.

Posted by schwitz at March 1, 2007 08:48 AM | TrackBack
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