HealthPartners says it will drop out of the network next year for UnitedHealthcare Medicare Advantage plans, claiming the nation’s largest health insurer has an excessively high rate of coverage denials and frequently delays payment for services used by seniors.
Bloomington-based HealthPartners, which is one of the largest operators of hospitals and clinics in the Twin Cities, is sending letters this week about the change to roughly 30,000 patients.
The health system will remain in-network through the end of the year, HealthPartners says, so patients don’t need to take any action now.
The change could be a factor, however, for seniors considering their options this fall in the annual open enrollment period for Medicare Advantage coverage. With these health plans, seniors opt to receive Medicare benefits through a private managed care health insurer.
“UnitedHealthcare delays and denies approval of payment for our patients’ Medicare Advantage claims at a rate unlike any other insurer in our market,” the letter states.
“At times, this denial rate has been up to 10 times higher than other insurers we work with. UnitedHealthcare’s practices create unnecessary waits and delays for [patients], and they interfere with our ability to provide … timely and appropriate care.”
UnitedHealthcare, which is the health insurance business of Minnetonka-based UnitedHealth Group, did not immedialy comment on the announcement.
The company has faced a series of questions over the past year or so about its coverage practices and policies.
Earlier this month, 11 people were arrested outside UnitedHealthcare’s headquarters in Minnetonka during an event spotlighting what protestors called a pattern of improper coverage denials by the health insurer.
In November, UnitedHealthcare was hit by a class-action lawsuit claiming the company used a faulty artificial intelligence algorithm to wrongly deny coverage for Medicare patients who need rehabilitation care following hospitalizations.
In July 2023, the U.S. Department of Labor sued a UnitedHealth Group subsidiary over allegations that the company wrongly denied thousands of claims to pay health care providers for emergency room services and urinary drug screenings.
This is a developing story. Check back for updates.
Source: HealthPartners pulling out of UnitedHealthcare’s Medicare Advantage network
