AHA, NILA Flag Concerning Actions by UnitedHealthcare

The National Independent Laboratory Association and American Hospital Association, bring to the attention of  the National Association of Insurance Commissioners, deeply concerning actions by UnitedHealthcare (UHC) to implement a new plan benefit design that will mislead patients and limit access to needed laboratory services. UHC’s Designated Diagnostic Provider (DDP) program, while couched in the terms of efficiency and quality, effectively creates a tiered benefit design under which patients would be unable to access services provided by in-network hospital and independent laboratories. Under this benefit design, UHC would effectively eliminate coverage for diagnostic tests at all independent and hospital laboratories, including those within its network, unless the facilities agree to participate in the DDP program. To date, UHC has only announced its intention to implement this plan design at the state level, subject to approval by state insurance regulators. For that reason, we urge the attention and opposition of the National Association of Insurance Commissioners (NAIC) and insurance commissioners in all states to implementation of this plan design. View the entire letter below.

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