UnitedHealthcare Issues Damaging ED Policy Designed to Increase Claim Denials

June 7, 2021

UnitedHealthcare (UHC) has announced a new policy for review of emergency department (ED) claims that would eliminate the prudent layperson standard from its initial adjudication of ED claims. GNYHA believes that this policy violates both insurance law and public health law and has sent the attached letter to the Department of Financial Services and the Department of Health requesting that they prohibit implementation of the policy in New York.

We believe this policy is intended simply to increase claim denials and payment delays and will advocate vigorously with the regulatory agencies to block its implementation. We will keep you apprised of all developments.

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