CMA has asked the Department of Insurance to require that United Healthcare rescind its new Advance Notification Protocol. This onerous protocol requires physicians to notify United before admitting patients to the hospital and mandates that if physicians don’t comply, they won’t be paid.
United is calling this “notification” rather than “preauthorization,” but is requiring physicians to provide the exact same information that other insurers require for preauthorization, without a guarantee of payment. In our request to the DOI, CMA set forth several problems with the protocol, including United’s failure to notify physicians in a timely manner of a material change to their contracts, as required by law. CMA believes the protocol is an attempt by the insurer to improperly insert itself into decisions regarding patient treatment.
CMA also believes that it unreasonable to expect a busy physician practice to allocate the time and resources necessary to comply with United’s protocol without a guarantee of payment. In order to be compliant with the protocol and to be eligible for payment, physicians may be forced to divert resources from patient care to administrative tasks.
This protocol is one of a series of policies recently announced by United that CMA believes are unfairly onerous, punitive to physicians, and detrimental to patient care, and that we are seeking to have overturned.
