Indianapolis-based Anthem says it will no longer pay for MRIs and CT scans in outpatient environments.
Anthem will no longer pay for the services for its fully-insured members in nine states. The insurer, for the time being, says that’s unless a review finds the scans were medically necessary to conduct in the hospital.
Hospitals in states affected by the policy change will likely have to confront their own bottom lines. Physicians in those states may also be forced to turn away patients.
Healthcare industry consultant Paul Keckley told Modern Healthcare Anthem’s move is the “beginning of the next wave of tension” as payers and hospitals go forward.