Medical tests, especially imaging tests, can save lives. They can also cost a lot. HMSA has tried to control those costs by requiring advance approval of MRIs by a contractor on the mainland. Let me show some extreme examples of the two sides of this issue.
Both HMSA and other health insurers have often said, as if it's an uncontested facts, that doctors order "too many" MRI and other expensive tests. There are several insurers who are convinced doctors order tests to inoculate themselves from malpractice claims.
But, on the other hand,local doctors say the Arizona contractor HMSA hired to pre-approve MRIs often denies approval, and even when approval is given, time is wasted, which could be critical when the patient has an aggressive cancer or some other illness that needs immediate treatment.
The legislature is considering a bill to forbid pre-approval and return discretion to doctors, but last week lawmakers called on the two sides to make a fresh attempt to work this out themselves, and discussions are indeed going on.
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