Cigna reverses course, expands hospital-based imaging access to pediatric patients

Cigna has reversed its controversial decision to stop covering most hospital-based imaging for pediatric patients, according to a letter sent to the American College of Radiology shared Thursday.

The commercial insurance giant first stopped covering most CT and MR imaging back in August and instead guided patients toward low-cost freestanding centers. The move prompted a stern letter from the ACR and Society for Pediatric Radiology warning the payment policy would have a “profoundly negative impact” on pediatric care.

In a response to that Nov. 24 letter revealed today, Cigna said it has revised its policy and expanded access to cover advanced hospital-based imaging in children 19 years or younger.

Both the ACR and SPR said they are “extremely appreciative” of the decision, which took effect on Feb. 22.

“The revised policy allowing children up to age 19 to access hospital-based advanced imaging will have a positive impact on the quality and safety of pediatric care for children and adolescents,” the ACR said in a Feb. 25 statement.

The advocates noted hospitals often staff pediatric radiologists, technologists and nurses who are specially trained to treat and interact with this younger patient population.

Other healthcare giants have come before Cigna in limiting imaging access to younger patients. In fact, Anthem, the second-largest payer in the U.S., was the first to do so back in 2017. United Healthcare had a similar policy on its books until radiology-led advocacy efforts communicated their concerns, ultimately pushing the insurer to revise its decision and extend coverage to children ages 19 and younger.

Read Cigna’s update to its “Site of Care: High Technology Radiology” policy here.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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