On June 1, UnitedHealthcare (UHC) launched a Gastroenterology Endoscopy Advance Notification Program. The program, for which physician participation is optional, follows months of ASGE advocacy to kill a prior authorization program after UHC refused to share data from within its own system that showed inappropriate use and geographic variation of endoscopy services.

UHC has stated it will use data collected through the Advance Notification process to “accelerate gold carding for eligible physician groups in early 2024.” UHC has not presented a specific timeline for implementation of its Gold Card program except to say it will be launched in “early 2024” and has not shared any information about the criteria by which gastroenterologists and other physicians who perform endoscopy services will be evaluated for gold carding eligibility. During a monthly meeting with medical association stakeholders, UHC representatives stated their expectation that approximately 10 percent of physicians would be eligible for endoscopy gold carding.

Moderators

Colleen M. Schmitt, MD, MHS, MASGE
Galen Medical Group
Chattanooga, TN

Joseph J. Vicari, MD, MBA, FASGE
Rockford Gastroenterology Associates, LTD
Rockford, IL

Lead Discussants

Bruce L. Hennessy, MD, FASGE
ASGE Health and Public Policy Chair
Ohio Gastroenterology Group, Inc., Columbus, OH

M. Mazen Jamal, MD
ASGE Practice Operations Committee Member
Founder, Oceana Gastroenterology Associates, Corona, CA

Inessa Khaykis, MD, FASGE
ASGE Practice Operations Committee Chair
Managing Partner, Vanguard Gastroenterology Group LLP, New York, NY

James J. Weber, MD
CEO, GI Alliance, Southlake, TX

Camille S. Bonta, MHS
ASGE Washington Representative
Principal, Summit Health Care Consulting, Breckinridge, CO

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