Delaware families continue to feel the effects of a rift between Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., and insurer UnitedHealthcare, according to The News Journal.
Last year, UnitedHealthcare notified Nemours it was terminating its contracts with Nemours/Alfred I. duPont Hospital for Children and Nemours duPont Pediatrics as of April 1, 2014.
Both sides failed to negotiate a contract, so families with UnitedHealthcare coverage who relied on Nemours for hospital, specialist and primary care were no longer able to, according to the report. Instead, they were forced to drive to Philadelphia and Baltimore to find a children's hospital, pay out of pocket or get a new insurance provider, if they could.
Nemours/A.I duPont Hospital for Children staff have expressed that that they believe the state has an obligation to intervene for the sake of Delaware children. However, members of Delaware Gov. Jack Markell's (D) administration, the Insurance Commissioner's Office and the attorney general "say their hands are tied," according to the report.
Delaware Attorney General Matt Denn told The News Journal he believes UnitedHealthcare and Nemours working together is a good business decision, but his opinion isn't pertinent to the situation. "Unless and until someone brings to our attention that someone is breaking the law, that is what triggers our office to do something. Medicaid had told us that United was in compliance of their network," he told the publication.
According to the report, Stephen Groff, director of Delaware's Medicaid program, pledged to lawmakers last month that the division would assess Medicaid plans provided by UnitedHealthcare as well as Highmark Blue Cross Blue Shield of Delaware.