Becker's Healthcare October 12, 2023
In 2021, insurer Aetna implemented a policy requiring Medicare Advantage patients to receive prior authorization for cataract surgeries nationwide. After receiving pushback from physicians, patients and advocates, it withdrew the policy in 2022 in every state except for Florida and Georgia.
This has caused continued procedure denials in the two Southern states, and industry groups have expressed frustrations, claiming that Aetna will not disclose its reasons for keeping the policy in place in just two states.
“While Aetna refuses to disclose its reasons, physicians suspect that it’s because of the states’ large senior populations that Aetna can target to line their pockets with money,” an ophthalmology group spokesperson told Becker’s in an Oct. 2 email.
Ninita Brown,...
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