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- UnitedHealthcare Responds to CAP About Designated Provider Program Concerns
UnitedHealthcare responded to the CAP’s and six other medical professional organizations’ objections to the insurer’s Designated Diagnostic Provider program. The groups had asked UnitedHealthcare to withdraw the updated program as it continues to undermine the patient-physician relationship, despite recent changes. The CAP works with private-sector insurers, like UnitedHealthcare, to safeguard access to pathology and laboratory services for patients across all settings.
The CAP was successful in getting UnitedHealthcare to make positive changes to the program after meeting with the insurer in 2021 and emphasizing the program’s burden and confusion, lack of transparency, and the potential for financial harm for patients. However, the CAP, along with the American Medical Association, the American Academy of Dermatology, the American College of Obstetrics and Gynecology, the American College of Rheumatology, American Society of Dermatopathology, and the Medical Group Management Association believe these changes did not go far enough and asked UnitedHealthcare to seek stakeholder input from physicians and medical groups on the Designated Diagnostic Provider program.
In its response, UnitedHealthcare refuted several of the objections, saying they want to “improve the quality and affordability of health care,” but are ready to meet and discuss further if needed. The CAP and the other groups remain concerned about the program’s design and unintended consequences for patients and are evaluating next steps.
The CAP will continue to engage with UnitedHealthcare on the Designated Provider Program and will update membership on any developments.