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.

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

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