Based on our decades of experience in reducing unnecessary surgeries, a multi-year, multi-state pilot on reducing unnecessary cataract surgeries, and national clinical guidelines and literature on surgeries, we believe up to 20 percent of all cataract surgeries may be unnecessary. In our outreach to the ophthalmology community of clinicians, we explained our rationale and discussed this new policy …… ensuring them we’d work collaboratively to make sure their patients and our members have timely access to appropriate, necessary care.

An Aetna spokesperson, commenting recently to HealthPayerIntelligence for its story, “Aetna Prior Authorization Policy Takes Effect, Providers Protest.” Aetna’s cataract surgery prior authorization policy went into effect on July 1 over ophthalmologists’ objections, the report noted.