UPDATE: Response from letter sent to Defense Secretary Chuck Hagel
United Healthcare concerns need to be addressed
Thursday a new twist in the United Healthcare saga. Congressman Doug Lamborn sent a letter to Defense Secretary Chuck Hagel about United's problems with providers and patients. A couple of hours later, he received a quick response from the Department of Defense about the problems.
The Department of Defense sent a response saying that United Healthcare will be bypassed at least through May 18th. Payments and Referrals will go through TriCare and directly to the providers.
Yesterday, I took you to a meeting between angry health providers and Congressman Doug Lamborn. Those providers say they and their patients aren't getting what was promised when United Healthcare won the contract to take care of Colorado and 20 other states in health management for the military and their families. The providers say referrals, payments and other issues are not being addressed by the company that took over the contract on April 1st.
As I told you yesterday, United Healthcare executive Matt Peterson admitted the problems are unacceptable and they would be fixed by the end of May.
Here is the text of the letter that Fifth District Congressman Doug Lamborn sent to the Defense Secretary:
May 2, 2013
Honorable Chuck Hagel
Secretary of Defense
Dear Secretary Hagel,
I am deeply concerned by a growing problem that TRICARE recipients in my district are facing since United Healthcare took over management of TRICARE West Region on April 1, 2013. Specifically, healthcare providers and recipients have told me that patient referrals are either not occurring or are severely backlogged. The result is that active and retired service members and their families are not receiving the critical medical care they need. This problem is widespread and includes critical health specialties where a month-long delay in receiving care could have a significant negative health impact.
Delays also mean that many of these medical providers are facing unexpected and dramatic reductions in their workload and are now faced with the prospect of laying off employees. In fact, I am aware of medical providers who may begin reducing their workforce within days. My understanding is there may be hundreds of thousands of pending referrals, delaying vital care for thousands of TRICARE recipients across the West Region. My staff has heard from one large provider that the delays in reimbursement are costing them tens of thousands of dollars per day.
While I understand that United Healthcare is working to resolve the problem, to date they have not been able to provide me with a clear process or timeline to resolving the problem. These service members and their families should not be stuck in limbo, waiting for important healthcare services, due to the mistakes of a contractor. Likewise, these healthcare professionals should not have to face job losses due to the mistakes of a contractor. Therefore, I ask that you immediately establish a temporary system to allow TRICARE recipients in the West Region to receive medical care. Also, I ask that you ensure timely payments to medical providers so that the professionals caring for our service members do not face job losses or undue financial strain.
United Healthcare has now had over a month to fix this problem, but has been unable to do so. TRICARE recipients and healthcare providers simply cannot afford to wait any longer. The situation is truly dire and I ask that you take immediate action to ensure the proper medical care of our service members and their families.
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