Minnesota Insurers Limit Coverage Of High-Tech Imaging Procedures

Newrestrictions by Minnesotainsurance companies on the use of high-tech imaging procedures have reduced thenumber of scans performed in the state, the St. Paul Pioneer Press reports. According to the PioneerPress, health care officials "dispute whether the restrictions havehealed or harmed the medical system," and physicians claim that"their time is wasted and their costs increased when they have to callhealth plans for permission to run a test."

However,insurers "anticipate millions of dollars in savings, which should lowerhealth care premiums for everyone," according to the Pioneer Press.Charles Fazio, chief medical officer for Medica, the second-largest insurer in thestate, said, "We think this gets to most of the overuse in imaging."The rate of high-tech scans among Medica's members has dropped by 10% since thecompany in March began discouraging physicians from imaging procedures notrecommended by the American College of Radiology, and the number of imagingrequests that do not follow medical guidelines also has decreased.

However, although physicians "agree the restrictions ... have haltedrunaway growth in imaging procedures," they "bristle when insuranceexecutives talk about the medical benefits," according to the PioneerPress.

Insuranceexecutives and physicians are working together to develop a centralized systemthat would give physicians immediate and consistent advice on whether a scanwould be covered, which would limit the "lost time and hassle" of thecurrent system and save money for insurers because they would not need to hirecontractors to evaluate physician requests (Olson, St. Paul Pioneer Press,11/28).

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