SCAI recommended that UnitedHealthcare make changes in its Prior Authorization Plan for lower extremity procedures prior to its implementation. These modifications will benefit patients by avoiding inappropriate denials and delays in care. These changes will also benefit UHC.  The numerous coverage appeals that will certainly be precipitated by these policies will be an unnecessary drain on resources. 

Our recommendations fell into three areas

  1. Reliance on resting ankle brachial index measures (ABI)
  2. Requiring  “At least twelve (12) weeks of a Supervised or Structured Exercise Program” and
  3. The 15 Day wait for prior authorization could cause harm to some patients.