ACR: Anthem’s new outpatient imaging policy is ‘arbitrary,’ ‘unwise’

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon

The American College of Radiology (ACR) has issued an official statement about Anthem’s new Imaging Clinical Site of Care program, calling it “arbitrary and unwise.”

The policy requires outpatient MR and CT scans not considered medically necessary to be completed at a freestanding imaging facility, not a hospital, in order to be covered. It went into effect in Indiana, Kentucky, Missouri and Wisconsin on July 1 and goes live in Ohio, Colorado, Nevada, Georgia and New York on Sept. 1.

“Economically motivated steerage of patients compromises the physician-patient relationship and undercuts integrated health care efforts,” the statement reads. “It also sets up another nontransparent preauthorization process that moves medicine backward.”

In the statement, the ACR also says it is “concerned that Anthem’s policy will force patients to locate an ever-declining number of freestanding imaging centers and/or physician’s officers to access imaging services.”

The full statement is not yet online—it was sent directly to Radiology Business—but it will be on the ACR’s website soon.

More information about the Imaging Clinical Site of Care program can be read here.