UnitedHealthcare is considering halting payments for computer-aided detection (CAD) services to 14.8 million people in its group of beneficiaries. In a recent announcement, UnitedHealthcare issued a statement that it would stop paying for CAD effective this week; however, the decision has been postponed till further notice.

The decision was based on what the company referred to as a lack of clinical evidence in support of CAD's effectiveness in improving the performance of mammography. The decision seems to be based on a study published in the April 5, 2007, edition of the New England Journal of Medicine. The study findings stated that CAD reduced the accuracy of screening mammography due to the impact of false positives on specificity. From this, UnitedHealthcare concluded that the technology is unproven.

With the announcement of postponement of its original decision, UnitedHealthcare now appears to be reversing its stance to cut CAD payments.

The American College of Radiology (ACR) sent UnitedHealthcare a letter in opposition to the policy after the original announcement to cut CAD services, and has been communicating with key executives at the payor.

Notes: DOTmed News has reported extensively on this issue. A similar policy decision and later reversal on the same matter was made by ODS Companies of Portland. (Go to www.dotmed.com/news/story/4434 or enter DM4434 into the search box.) Other related stories are DM3615 and DM3689. Read the ACR position in DM3703. Also reported previously in DOTmed News, beginning March 1, 2008, UnitedHealthcare will require accreditation for medical imaging reimbursement.

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