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Life Health > Health Insurance > Your Practice

Cornhusker Regulators Act Against Health Carrier

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The Nebraska Insurance Department has scheduled a hearing on concerns about units of UnitedHealth Group Inc. for Feb. 14, 2007.

The units, including UnitedHealth’s main managed care and behavioral health units in Nebraska, have been generating too many consumer complaints since 2003 and have not done enough to cooperate with the department, department officials contend in a petition discussing the reasons that the department has called the hearing.

UnitedHealth executives have been promising to respond to department concerns since September 2004, but “despite these assurances, consumers continued to complain to the department,” the department says in the petition.

The department alleges, for example, that one UnitedHealth unit appears to have been failing to meet health care decision appeal grievance committees. A medical doctor was advising the 7 individuals who could serve on the grievance committee, but only 2 were health care professionals, and members of another unit’s review committee included a network management executive and a sales and marketing executive, the department says.

Units also described appeal time tables incorrectly and, in some cases, failed to respond or failed to respond promptly to department requests for information, the department says.

UnitedHealth was startled by the hearing petition, because Nebraska insurance officials have indicated in recent months that the company has been making progress with improving its operations, UnitedHealth spokesman Tyler Mason says.

In October, for examples, Nebraska Insurance Director Tim Wagner reportedly told the Lincoln Journal Star that UnitedHealth’s operating companies were doing everything they could to address doctors’, hospitals’ and patients’ complaints about problems with payment delays.

Wagner also said UnitedHealth’s complaint numbers were down.

“We’ve been cooperating,” Mason says. “We’re trying to be approachable.”


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