PROVIDENCE – If no new contract is reached between UnitedHealthcare of New England and Care New England before the current contract expires on Dec. 31, patients will still be able to use Care New England facilities in “a seamless access” until the R.I. Department of Health makes a final decision on UnitedHealthcare’s material modification application, Annemarie Beardsworth, public information officer for the R.I. Department of Health, announced Tuesday.
UnitedHealthcare has agreed to send a letter to all members clarifying this arrangement, according to Beardsworth.
Any time a health insurer anticipates a significant network change offered in its health plan, such as a hospital dropping from its plan, the insurer must apply to the R.I. Dept. of Health for approval of its “material modification” plan, according to Beardsworth.
However, the R.I. Dept. of Health said that it had found that UnitedHealthcare’s application for material modification to be incomplete.
“United has submitted an application…however, the application has not been deemed complete,” said R.I. Dept. of Health officials in a news release.
“Therefore, there is not enough time in the 2010 calendar year for [the R.I. Dept. of Health] to review and act upon the application before the current contract expires. Because [the R.I. Dept. of Health] has not approved the material modification application, United must continue to provide the same seamless access to [Care New England] providers for all of its members.”
The R.I. Dept. of Health will post any updated information on its website at www.health.ri.gov.
