Health insurers and employers, looking to ease mounting medical costs, are again tightening their control over big-ticket procedures and drugs, according to a study by the Center for Studying Health System Change, Washington. In the late 1990s, many health plans responded to consumer demand by easing utilization restrictions and eliminating preauthorization requirements for specialty care and many tests and procedures. But the 2002-03 survey of healthcare leaders in 12 U.S. cities found that many health plans are reintroducing prior-approval requirements for certain services considered the highest cost or most prone to overuse, including chiropractic care, diagnostic imaging, outpatient surgery, plastic surgery and physical therapy. Insurers and employers also are requiring more prior approvals for prescription drugs that are often abused, such as Viagra and OxyContin, the study found. Read the center's issue brief. -- by Laura B. Benko
Prior approval re-emerges as cost-control tool
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