Here are three major moves from payers that ASC leaders need to know:
1. UnitedHealthcare plans to cut back on its use of prior authorization, removing procedures and medical devices from its list of services requiring signoff and reducing the number of authorizations from 13 million to 10 million annually.
Several procedures and devices will be removed starting in the third quarter. The insurer also plans to automate and speed up prior authorization over the next several years, according to the report.
2. AmSurg's more than 250 surgery centers are now in-network with Aetna after Envision Healthcare signed a multiyear deal with the insurer.
AmSurg operates surgery centers and facilities across the U.S., focused primarily on ophthalmology and gastroenterology. AmSurg has facilities in 34 states and around 2,000 physicians in its network.
3. As of March 12, Cigna is lowering reimbursements for non-medically directed procedures performed by certified registered nurse anesthetists by 15 percent.
Cigna will lower its reimbursement for claims submitted with the QZ modifier, which indicated a non-medically directed CRNA service. The payer cited evidence-based medicine, society recommendations, CMA guidance and industry standards as supporting the shift.