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In This Issue
Past Newsletters
- September 2017
- Sept. 13 MLR Checks Mail
- Sept. 28 Rx Prior Authorization, Medicare Cards
- August 2017
- Aug. 9 Transitional Relief Update
- Aug. 23 Medicare Creditable Coverage Mandate
- July 2017
- July 12 Digital Onboarding
- July 26 PCORI Fee Due July 31
- June 2017
- June 14 MLR Schedule Released
- June 28 Data Assessment Requirement
- May 2017
- May 10 IRS 6055 Collection Data
- May 24 IRS Issues 2018 HSA Amounts
- April 2017
- April 12 New Preventive Measures Announced
- April 26 New Client Tracking Tool Introduced
- March 2017
- March 8 ACA Update for Aggregate Groups
- March 22 July 1 PDL Changes
- February 2017
- January 2017
- Jan. 11 Broker Bonus Announced
- Jan. 25 Court Bans Gender Enforcement
- December 2016
- November 2016
- Nov. 9 IRS Releases New FSA Amounts
- Nov. 23 CMS Ratings Released
- October 2016
- Oct. 14 Section 1557 Update, Reinsurance Notice
- Oct. 26 Reinsurance Quiz
Local and Other News
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Section 1557 of ACA Results in Claim System Updates
October 4, 2016
Currently, age and gender edits are applied during claims processing to avoid incorrect payments due to billing and data entry errors. With recent guidance under Section 1557 of the Affordable Care Act (ACA) nondiscrimination provision, UnitedHealthcare will make a number of modifications to existing edits effective Jan. 1, 2017.
Claim submission errors based on age or gender are infrequent, and we anticipate a negligible financial impact. Removing the edits supports plan compliance with anti-discrimination laws.
Gender edits for preventive services in 2015 have been removed. Age edits will continue to be in place when based on clinical or evidenced-based guidelines.
We will continue to monitor fraud, waste and abuse, and those situations will be handled accordingly. For more information, please contact your UnitedHealthcare representative.
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January 1, 2017 PDL Updates
The following updates will take effect for the OptumRx direct Prescription Drug Lists (PDLs) on January 1, 2017. Learn more
New Sales Automation Management Tool
Check out our new Sales Automation Management (SAM). Learn more
UnitedHealth Group News
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