ACEP ID:

June 11, 2021

Aggressive Advocacy Results in Reversal of UnitedHealthcare Policy that Would Allow Retroactive Coverage Denials for Non-Emergent Cases

Update (June 17): ACEP and 32 organizations comprising patient advocates, hospitals, and physicians across medical specialties sent a letter to UnitedHealthcare (UHC), calling to permanently abandon its planned policy to retroactively deny patients’ emergency care claims. 

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When UnitedHealthcare announced its new emergency department coverage policy that would allow the insurer to retroactively deny ED claims it determines are nonemergent, ACEP immediately responded with a strong public rebuke of this dangerous policy. This statement kicked off six days of aggressive advocacy that resulted in UnitedHealthcare delaying its policy until the end of the public health emergency for COVID-19. 

“While it’s a relief that patients will get a short-term reprieve, United Healthcare is not getting rid of this dangerous policy - only delaying it," said ACEP President Dr. Mark Rosenberg. "However, medical emergencies will continue to happen beyond the pandemic, and ACEP remains committed to advocating on behalf of patients and their ability to seek emergency care when they think they need it.”

ACEP's advocacy cut across multiple tactics, including:

  • The aforementioned media statement that got wide traction on Twitter, more than a million impressions and more than two thousand retweets and likes. 
  • Significant media interest coordinated by our PR department that resulted in public outcry and Congressional scrutiny (see below):
  • Congressional scrutiny, including ACEP helping to draft a question on the UnitedHealthcare policy for Senator Cardin, who asked it of HHS Secretary Xavier Becerra in a Senate hearing on June 10. Of note, Sec. Becerra responded, “We are hoping that with more people who sign up with ACA, fewer people will be reluctant to use the ER.” 
  • Coordination on messaging and strategy with hospital groups

To be clear: Our advocacy work isn’t done. UnitedHealthcare's language leaves them room to try again—though hopefully the swift backlash will make other insurers reconsider for the time being. ACEP is developing a sign-on letter for medical societies, hospital associations, and consumer groups to help us push back on this dangerous policy.

Advocacy works. When our membership unites behind a cause, our voice is heard loud and clear.

ACEP members are invited to get more involved by joining the 911 Grassroots Network, including more than 6,000 ACEP and EMRA members who are actively engaged in emergency medicine advocacy.

Bookmark the Advocacy Action Center to see all current advocacy alerts. Right now, you can support our efforts to increase health care worker access to mental health care by sending your legislators a quick message asking them to co-sponsor the Dr. Lorna Breen Health Care Provider Protection Act. 

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