The COVID-19 pandemic has forced cardiovascular practices to adapt to new staff and patient scheduling and test selection processes. ACC understands there will be various protocols for deciding on specific cardiovascular tests largely based on practice, clinician and patient preference. However, there is a concern that payers and radiology benefit managers (RBMs) are not approving these tests.

The College has developed an "open letter" to health plans and their RBMs urging "additional flexibility for all procedure and testing decisions" during the COVID-19 pandemic. The letter also specifically recommends payers and prior authorization vendors suspend any requirements for an initial cardiac exercise/treadmill/bicycle stress test when assessing patients for coronary artery disease. Additionally, the letter requests payers and prior authorization vendors remove any restrictions or barriers on cardiovascular imaging tests.

Along with the letter, the ACC is seeking to better understand clinician and/or practice experience with prior authorizations under new COVID-19 protocols. Specifically, are RBMs requiring exercise stress testing? Are requests for stress echo, SPECT, PET, CCTA and CMR being approved? Which payers and RBMs are causing the most difficulty? Feedback can be sent through the ACC PARTool at ACC.org/PARTTool.

Clinical Topics: COVID-19 Hub, Atherosclerotic Disease (CAD/PAD)

Keywords: ACC Advocacy, Coronavirus, Coronavirus Infections, Exercise Test, Coronary Artery Disease, Prior Authorization, COVID-19, severe acute respiratory syndrome coronavirus 2

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