Milwaukee – After raising concerns that United Healthcare (UHC) was not covering addiction treatment for addicts needing Intensive Outpatient Program (IOP) treatment, UHC responded by stating that there was confusion earlier this year regarding a change in the way UHC billed for Medicaid behavioral health services, specifically for Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) services. UHC states that they’ve worked closely with providers to ensure continued access to care and services is restored.
Advocaid however believes that UHC, during the period of “confusion”, has caused harm to our community in order to line their pockets by not paying for needed services.
UHC puts the blame on reimbursement codes and billing processes. UHC states that initially they “notified providers that services utilizing specific reimbursement codes would not continue to be reimbursed because they were not covered under Wisconsin’s Medicaid program.”
After several letters demanding a meeting with the CEO of UHC, a representative of UHC notified Advocaid that the confusion was cleared up after “DHS clarified that some of these services are covered and reimbursable when utilizing the appropriate billing methodology.”
However, this explanation still does not answer Advocaid charge that UHC violated, and we feel is still violating, Parity Law by Red Lining our community by not providing contracted services to providers in our community. By not contracting with providers dedicated to Central City opioid recovery, UHC is making it difficult for addicts to get the needed help without traveling long distances for treatment.
Advocaid is passing on this information to our partners and other groups experiencing issues regarding treatment for addicts in the central city.
If any member/addict of your group is having issues being given treatment due to coverage, Advocaid advises that you contact UHC member advocates by calling 1-888-246-8140. Further, any care provider having issues with getting treatment for their members can call with questions 612-632-6366.
Finally, Advocaid continues to raise awareness of Red Lining/Parity Law violation and calls on state and local government to review this unjust practice.
To defeat Red lining practice, Advocaid is joining with former Congressman Patrick J. Kennedy who is pushing for full enforcement of the Mental Health Parity and Addiction Equity Act of 2008. He was the lead sponsor of the legislation. His organization, The Kennedy Forum, recently launched major tools to track parity issues across the county. The data will help to shape public policy and influence legislation.
Advocaid encourages our partner groups and other organizations to go to the website provided below and encourage your followers (providers and consumers) to register formal complaints here: http://www.parityregistry.org.
“We will be following up with UHC soon regarding our recent findings”, Miranda.
