Nation’s largest Insurer Puts Sharp Limits on the Most Common Form of Hysterectomies

UnitedHealthcare (UNH) has sent out a bulletin to physicians saying that it will start denying coverage for laparoscopic or abdominal hysterectomies in April unless the doctor gets pre-authorization.

The insurer says it believes vaginal hysterectomies, which account for only 22% of the more than 500,000 hysterectomies a year, are the preferred form and will not require pre-authorization.

The insurer cited the finding of the American Congress of Obstetricians and Gynecologists that “evidence demonstrates that, in general, vaginal hysterectomy is associated with better outcomes and fewer complications than laparoscopic or abdominal hysterectomies.”

United Healthcare’s notice said physicians who do not get preauthorization for the procedure will have their claim for compensation denied. It said the doctors will not be allowed to bill their patients for the procedure.

That will essentially stop physicians from performing the procedure for most of the more than 40 million female members covered by the insurer, since their inability to bill those patients will mean they can’t even pay out of pocket for the procedure.

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