Tricare extends changes to UnitedHealthcare military plan

  • Article by: JIM SPENCER , Star Tribune
  • Updated: May 20, 2013 - 8:25 PM

Tricare officials cited continuing delays in approving patients’ referrals to specialists.

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United Healthcare's headquarters building in Minnetonka.

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– The Defense Department has extended for another month measures to address problems with United­Healthcare Military

The government will continue an automatic referral and approval process for specialized care, because of United­Healthcare’s difficulty in providing timely care for certain service members, military retirees and their families.

That service is “still not to the point where we’re comfortable,” said Austin Camacho, a spokesman for the federal Tricare insurance program.

UnitedHealthcare began administering the program in Tricare’s 21-state western region on April 1. But after numerous complaints from care providers, Department of Defense officials judged UnitedHealthcare’s delays in approving patient referrals to specialists unacceptable and forced the company to temporarily waive its approval process for 1.6 million people in a managed care program.

That waiver was to expire Saturday, but the government extended it until at least June 18, when Tricare officials will once again judge the speed with which UnitedHealthcare is providing care.

The company blamed an unexpected volume of specialty referrals for the approval backlog and pledged to devote as many resources as necessary to catch up and maintain an acceptable level of performance.

“We are making significant progress in processing all pending referrals and authorizations to ensure uninterrupted specialty care for Tricare West Region beneficiaries,” spokesman Bruce Jasurda said.

UnitedHealthcare Military & Veterans said in a statement Monday that it is processing urgent referrals and authorizations promptly to ensure access to care. The company also said it is devoting additional resources to expedite processing of all routine requests.

UnitedHealthcare Military & Veterans is a subsidiary of Minnetonka-based UnitedHealth Group. It was formed specifically to attract Tricare business.

The company last year won an embattled $20.5 billion contract to administer Tricare’s West Region. But delays in care delivery led to government criticism and intervention only a few weeks after UnitedHealthcare applied its administrative protocols.

Camacho said the government continues to meet with UnitedHealthcare officials daily to judge progress in working out bugs in the system that caused many patients to wait weeks for approval of payment for needed treatments.

“I know they have plussed up the number of people working on this,” Camacho said.

He said the government will decide later whether to penalize UnitedHealthcare Military & Veterans for its poor initial service.

Jim Spencer • 612-673-4503

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