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(UnitedHealthcare) Insurance Giant Prioritizing Profits Over Patients : ThyBlackMan com
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Federal Plan to End Surprise Medical Bills Draws Mixed Reactions
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New UnitedHealth policy ends some non-emergency coverage
UnitedHealth Group will no longer cover members non-emergency services from out-of-network facilities, effective July 1.
The policy change will impact everyone from individuals seeking addiction treatment at day facilities to those who want rehabilitative services after a knee surgery at locations not in-network. Any non-emergent sub-acute inpatient and outpatient services that are out of network will be impacted, which essentially includes step down medical and behavioral healthcare at skilled nursing facilities or residential treatment programs. UnitedHealthcare has one of the largest care provider networks in the country, a spokesperson wrote in an email. We encourage our members to see these providers whenever they can as they have the lowest out-of-pocket costs. We recognize at times our members may need to see out-of-network providers and most of our plans also offer out-of-network benefits in their service are
Modern Healthcare Illustration / Getty Images
With five months before the surprise billing ban takes effect, the Biden administration hasn t released many of the most important details about how the No Surprises Act will work, leaving providers and insurers little time to plan for the changes.
CMS first rule outlawing balance billing contained expected patient protections against surprise billing and high cost-sharing for out-of-network care, as outlined in the December law.
But providers and insurers are still in the dark about the independent dispute resolution process and how regulators will define key terms for arbitrators or calculate median in-network rates. It s not really what providers or payers were looking for, Avalere Health consultant Tim Epple said. I don t think there is anything that we ve seen that differed meaningfully from the legislative text or the intent of the statute.