Prior Authorization | ASCRS
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ASCRS GOVERNMENT RELATIONS

Make your voice heard against aetna

The decision by Aetna to require preauthorization of all cataract surgery procedures went into effect July 1. This policy is creating overly burdensome amounts of work for ophthalmic practices, resulting in the cancellation of previously scheduled cataract surgeries that have not been able to receive this preauthorization. It will result in delays of future cataract surgeries. It also sets a dangerous precedent for other insurance companies to follow suit if Aetna’s policy sticks. 

Aetna's Policy Cannot Stand

ASCRS, along with the American Academy of Ophthalmology and the American Society of Ophthalmic Administrators, has been advocating on behalf of its members since it learned of Aetna’s plan to institute this policy. We remain vigilant in our effort to get this policy rescinded on behalf of our ophthalmologist members and their patients.

You should be aware of the efforts being made to impact change. 

  • meeting was held with Aetna to get answers and make the collective voice heard. 
  • ASCRS issued a press release to generate public attention to this issue.
  • ASCRS and its leadership is in direct contact with Aetna, imploring it to rescind this policy.

We Need Your Help

This issue of Aetna requiring prior approval of cataract surgery procedures continues to be our top priority, but success of rescinding this policy also requires a grassroots effort from you, our member ophthalmologists. Here’s what you can do to help:

1) Email Aetna. Share your personal story of how this decision is impacting you, your practice, and your patients with Scott Spradlin, Aetna’s Vice President of Clinical Strategic Operations and Policy Delivery (sspradlin@aetna.com), and Anil Goyal, MD, Aetna’s Medical Director (goyala2@aetna.com). 

2) Contact your local media. We created this press release for you to share with your local media (TV, newspaper, etc.). If you have personal examples of how Aetna’s policy has delayed or denied your own patients’ care, offer to speak about those. Find local media contact information on their websites or reach out to them on their social media pages; they can help get the word out about how this policy negatively impacts people in their own community. 

3) Encourage Patients to Voice Concerns. ASCRS and ASOA have crafted a message patients can send to Aetna voicing concerns about delayed access to care. Practices should email their Aetna patients directly, notifying them of the new prior authorization policy that could cause a delay in their care, and urge them to express their frustration by submitting an email to Scott Spradlin, Aetna’s Vice President of Clinical Strategic Operations and Policy Delivery (sspradlin@aetna.com), and Anil Goyal, MD, Aetna’s Medical Director (goyala2@aetna.com).

4) Keep ASCRS informed. Stay connected with us on our social media channels to get updates and share your stories so we can continue to advocate on your behalf. If you have experienced any issues with getting approval or have a patient story to share, contact ASCRS Government Relations at jwinans@ascrs.org. We will use these stories in our efforts to get this policy rescinded.

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