State to Insurance Company: Not so Fast

The health insurer United Healthcare has been planning a benefit change whereby patients would be required to receive outpatient elective advanced radiologic imaging (that’s MRIs and CT scans) in non-hospital settings (with some exceptions).

MHA reviewed the policy and determined that there are not enough freestanding CT providers to fulfill the insurer mandate, and discovered numerous errors and faulty listings in United’s provider directory – the document consumers use to find a facility to conduct the CT scan.

MHA wrote the state Division of Insurance about the problem and DOI delayed the insurer from imposing the change from the original implementation date of January 1 to the new date of April 1. MHA, DOI, and hospitals will continue to monitor the situation.