UnitedHealthcare uses a bulk recovery process in order to recover overpayments due from providers who have refused to voluntarily refund them. That process has been the subject of legal challenges, which have now resulted in an appellate court ruling. Below is an update on planned customer communications regarding the recent ruling.
On Jan. 15, the 8th Circuit Court of Appeals affirmed an earlier decision from the Minnesota district court, finding that UnitedHealthcare plans require more express authorizing language to permit bulk recovery – also known as cross-plan offsets. The ruling is limited to certain older UnitedHealthcare plans at issue in the litigation. UnitedHealthcare’s template plan language has for years included language expressly authorizing bulk recovery through offset, and that language has been adopted by many customers. Those updated plans are unaffected by this ruling. Other plans that continue to wish to participate in cross-plan offsetting may do so under this ruling by adopting the more explicit authorizing language.
To ensure all existing self-funded (ASO) customers understand UnitedHealthcare’s bulk recovery process, a customer letter has been prepared to send by email to each self-funded customer. The customer email contains a letter that gives notice as to how the bulk recovery process works, the risks and benefits it brings to the customer, and customer instructions to reach out to their UnitedHealthcare representative for next steps if necessary. It also provides an update on litigation. There are two versions of the letter – customers will either receive a letter informing them that their Summary Plan Description (SPD) contains updated language, or a letter explaining that their SPD does not contain the updated language. These letters will be sent to self-funded customers by March 4th.
If your self-funded client has questions about UnitedHealthcare’s Bulk Recovery please share the “UHC Bulk Recovery Process Description” document with them and reach out to your UnitedHealthcare representative with further questions.