UnitedHealthcare to Delay New Policy that Would Deny Coverage for Some ED Visits

After Concerns from the AHA and Others, UnitedHealthcare Will Delay New Policy that Would Deny Coverage for Some ED Visits

AHA Special Bulletin
June 10, 2021

UHC statement reported by the New York Times says it will delay policy through the end of the COVID-19 public health emergency

After concerns raised by the AHA and other health groups, UnitedHealthcare today announced that it would delay until the end of the COVID-19 public health emergency its recently-announced policy that would have retroactively denied coverage for emergency department claims the insurer deemed non-emergent. The policy was supposed to take effect July 1.

“Based on feedback from our provider partners and discussions with medical societies, we have decided to delay the implementation of our emergency department policy until at least the end of the national public health emergency period,” UnitedHealthcare said in a statement reported by the New York Times this morning.

AHA on Tuesday sent a letter to UnitedHealthcare expressing concern with the policy, saying it would put patients in jeopardy, and urging the insurer to reverse the policy immediately.

“Patients are not medical experts and should not be expected to self-diagnose during what they believe is a medical emergency,” AHA wrote in its June 8 letter. “Threatening patients with a financial penalty for making the wrong decision could have a chilling effect on seeking emergency care. This is dangerous for patients’ health at any time, but is particularly unsafe in the midst of a public health emergency.”

In its letter, AHA also urged UnitedHealthcare to evaluate whether the insurer’s other policies that restrict enrollees’ coverage for a wide range of hospital outpatient department services may contribute to access challenges for patients. AHA will continue to press the insurer on issues that put patients’ health and wellbeing in jeopardy.

FURTHER QUESTIONS
If you have questions, please contact AHA at 800-424-4301.

Related Resources

Letter/Comment
America’s hospitals and health systems are deeply concerned by UnitedHealthcare’s (UHC) recent policy announcement to allow for the retroactive denial of…
Fact Sheets
Some employers are moving away from offering traditional coverage with a provider network and instead are using reference-based pricing for some or all of…
Special Bulletin
Public
The AHA expresses concern to UnitedHealthcare regarding its recent policy announcement to allow for the retroactive denial of coverage for emergency-level care…
Letter/Comment
Public
AHA and the National Independent Laboratory Association flagged for the National Association of Insurance Commissioners deeply concerning actions by…
Letter/Comment
Public
The AHA and American Society of Health-System Pharmacists urge the Food and Drug Administration to take appropriate enforcement action to protect patients from…
Letter/Comment
Member
AHA urges the Centers for Medicare & Medicaid Services to align the Hospital Price Transparency Rule with new transparency requirements included in the No…