UnitedHealthcare came under fire from the AHA and other healthcare organizations in 2021 over its attempts to reform its emergency care coverage. The payer unveiled a policy that would allow it to deny coverage of emergency room visits if an internal investigation found the condition did not require emergent care.
The payer later announced it would delay integrating the policy after receiving feedback from providers, but some groups, including the Federation of American Hospitals, demanded UnitedHealthcare permanently rescind the policy.
AHA described similar fears in a Dec. 29 bulletin, claiming UnitedHealthcare sought to go forward with changes to its emergency coverage criteria and expressed its disapproval of the policy. According to the bulletin, the payer would have allegedly rolled out the changes Jan. 1.
However, in a Dec. 30 letter responding to AHA, Mr. Thompson said UnitedHealthcare would not be making any changes to its policies.
"Our intention to align coverage definitions with the new guidance created confusion rather than clarifying matters," he wrote. "To reiterate, there is no new policy regarding coverage criteria for emergency care being implemented on Jan. 1, 2022. Further, UnitedHealthcare has no intention of implementing any such new policy for its fully insured business."
An AHA spokesperson told Becker's that it takes UnitedHealthcare at its word that the organization misinterpreted the payer's language.