What’s that saying? When you find yourself in a hole, quit digging?
Looks like UnitedHealthcare (United) finally caught wise that attempting to implement stricter criteria for emergency services was ditch-digging at its finest.
In June 2021, the company announced that it would stop paying for “nonurgent” ER visits – a stance it quickly backed away from as outrage ensued over how patients are supposed to know the difference between, say, indigestion and a heart attack, or a migraine or a stroke.
Initially UnitedHealthcare framed it as a pandemic delay, but they’ve now made the backtrack an official stance. The company seems to have realized that threatening patients with out-of-network ER bills isn’t a popular concept with consumers, hospitals, or regulators.
In a recent article in Healthcare Dive, the nation’s largest private health insurer told the American Hospital Association that it has “no intention” of implementing the strict policy it first announced back in the summer. United claims the confusion was due to unclear language in its guidelines.
But the federal Centers for Medicare & Medicaid Services may have had something to do with it, too. After United floated their initial proposal, CMS turned around and proposed a surprise billing ban that prevented insurers from denying emergency services coverage to its patients.
For now, United has admitted that the jig is up. The reality of telling patients that they need to know – in advance – whether their condition might kill them – just isn’t going to fly. Nor should it.