Mid-Atlantic Health Plan updates on ENRP and Shared Savings Program

Updates to the Extended Non-Network Reimbursement Program (ENRP), including UnitedHealthcare reimbursement for some services rendered by physicians, other health care professionals and facilities that do not participate in the UnitedHealthcare network (“non-network providers”) will take effect on May 1 for new business and renewals. This change impacts fully insured Key Accounts and 51+ groups sitused in DC, VA and WV.

  • Policy situs state drives applicability of ENRP (not residence state or where care is delivered).
  • Applies to all products in DC, WV and VA, except non-differential plans.

Additionally, the Shared Savings Program will be discontinued on May 1, 2020.

We recommend that you encourage members who plan to receive health care services to talk to their doctors about all of the providers that may be involved in their care and make every effort to use only providers who participate in the UnitedHealthcare network. 

Please refer to this flier for more information.

Please contact your UnitedHealthcare representative with questions.  

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