In letters sent Monday to CMS officials, the American Hospital Association (AHA) and the Federation of American Hospitals (FAH) pointed to a coverage policy for inpatient hospital care distributed by UnitedHealthcare and set to go into effect Jan. 1.
That policy “blatantly violates” coverage criteria revisions included in the calendar year 2024 MA final rule that prohibit MA plans from limiting or denying coverage for hospital services that would be covered under traditional Medicare, FAH President and CEO Chip Kahn said in a statement accompanying his organization’s letter to CMS.
“Among other concerns, UHC continues to use proprietary software that unlawfully narrows MA beneficiaries’ inpatient hospital benefits, creating patient care risks as well as higher cost-share burdens,” Kahn said. “Medicare beneficiaries should not be shortchanged by UnitedHealthcare or any MA plan. We have flagged UnitedHealthcare’s unlawful policies for CMS and pledge to work with the Agency to ensure Medicare’s coverage policies for all of America’s seniors.”
https://www.fiercehealthcare.com/pa...tantly-violates-new-cms-coverage-requirements
That policy “blatantly violates” coverage criteria revisions included in the calendar year 2024 MA final rule that prohibit MA plans from limiting or denying coverage for hospital services that would be covered under traditional Medicare, FAH President and CEO Chip Kahn said in a statement accompanying his organization’s letter to CMS.
“Among other concerns, UHC continues to use proprietary software that unlawfully narrows MA beneficiaries’ inpatient hospital benefits, creating patient care risks as well as higher cost-share burdens,” Kahn said. “Medicare beneficiaries should not be shortchanged by UnitedHealthcare or any MA plan. We have flagged UnitedHealthcare’s unlawful policies for CMS and pledge to work with the Agency to ensure Medicare’s coverage policies for all of America’s seniors.”
https://www.fiercehealthcare.com/pa...tantly-violates-new-cms-coverage-requirements
