Uploaded via media manager.

UPDATE: Message About Continuity of Care for Patients on UnitedHealthcare AARP Medicare Advantage Plans

United AARP Medicare Advantage patients can continue seeing ARC doctors in 2018 and can stay with ARC doctors by choosing a Medicare Advantage plan that ARC accepts in 2019

ARC will not be in network with any UnitedHealthcare (UHC) Medicare Advantage plan, including the AARP Medicare Advantage plans, for the entirety of 2019. In the past two days, we have received hundreds of calls from concerned patients and have learned that UHC is interrupting patients’ access to ARC doctors, risking patients’ health and well-being. What we hear most from you is that you want to know how you can stay with your ARC doctor. Here is what we know, and what we’re doing to give you time to make a health choice that’s right for you.

If you re-enroll with UHC Medicare Advantage, access to your doctor will change in 2019

Beginning January 1, 2019, Austin Regional Clinic (ARC) will not be contracted with any of the UnitedHealthcare (UHC) Medicare Advantage Plans. What this means for you is, if you remain on one of these plans next year, UHC will require you to select another doctor who is not part of ARC.

You can stay with your doctor if you choose a plan that includes ARC providers in 2019

Most other Medicare Advantage plans serving the Austin metropolitan area will include ARC doctors in their network in 2019. To stay with your ARC primary care physician (PCP) or any of your other ARC doctors, you will need to pick one of those plans during this year’s Medicare Annual Enrollment Period, October 15 – December 7, 2018.

This happened because ARC and UHC could not come to an agreement about 2019

ARC is actively investing in programs that provide access to high quality coordinated care to more of our patients. With seven years of proven success in our patient-centered medical home program, we decided to expand it in 2019 for our Medicare Advantage patients. This expansion of health care services requires renewed discussion with our health plan partners. While our approach was welcomed by many MA health plans, that approach did not meet UHC business plans, we fully respect that. As a result, ARC and UHC AARP mutually agreed to terminate our Medicare Advantage contract effective 12/31/2018.

It was ARC’s expectation that there would be an orderly education and transition process for health plan members that would occur over the four-month period from September 1 - December 31. That orderly process has not occurred.

We assure you that our ARC doctors can continue your care through 2018 on your UHC AARP plan

You deserve time to make the best healthcare choice for you. ARC takes your trust in us very seriously and we honor the patient-physician relationship.  We remain committed to your health and well-being regardless of the actions of UHC. We assure you that you can continue your care with ARC providers and services, such as lab or radiology performed at ARC, through the remainder of 2018.

We want you to keep your ARC appointments with any of our providers and we will continue to refill your prescriptions as usual

You will still be responsible for the routine patient portion for your visit – copays, coinsurance, and deductibles. We will continue to work with UHC and hold them responsible for paying their portion of your insurance coverage and honoring their contract with ARC.

ARC has no control over referrals and authorizations for care rendered outside of ARC through December 31, 2018

If we have submitted an authorization or referral request to UHC, or if you have something scheduled with a non-ARC specialist or at a non-ARC facility, all we can do is continue to put pressure on UHC to approve our referrals and authorizations. We are working around the clock to make sure you receive the care that you need by the providers you chose for this plan year.

Medicare Advantage patients have options to stay at ARC in 2019

We’d like to continue caring for you regardless of what UHC has told you. You can make an informed decision about your 2019 health plan based on what is important to you during Medicare Open Enrollment, October 15 – December 7, 2018. Most other Medicare Advantage plans in the Austin area will include ARC doctors in their network in 2019. Beginning October 1, you can review the benefits and networks offered by all Medicare Advantage plans and we will have the plans ARC accepts listed at AustinRegionalClinic.com.

There are trusted resources to help you choose a plan for 2019. If you’re confused by any messages sent about your ARC doctor, don’t hesitate to contact the ARC-INFO phone line, Mon-Fri 8am – 5pm at 512-272-4636 (512-ARC-INFO). We can also refer you to Medicare licensed insurance agents for expert advice.

A licensed insurance agent can help you understand differences in coverage, out-of-pocket expenses, and access to the physicians you need to continue your care. If you would like to work with a licensed insurance agent familiar with this change at ARC, at no cost to you, please email us at MedicareInfo@austinregionalclinic.com or call 512-272-4636 (512- ARC-INFO), and you will be contacted after October 1. The agent will give you information and advice. Any decision will be yours to make.

Voice your concerns

Many patients have asked us “What can I do?” Here are some things you can do to take action:

  • File a formal expedited appeal on the UHC Medicare Plan Appeals and Grievances Form
  • Click here to contact your Texas Congressional Representatives and Senators.
  • File a formal complaint with the Center for Medicare and Medicaid Services (CMS)
    • Call 1-800-HHS-TIPS (1-800-447-8477).
    • Email: You can also send up to 10 pages describing the incident to HHSTips@oig.hhs.gov.
    • Fax your report (up to 10 pages) to 1-800-223-8164.

Our number one priority for the remainder of 2018 is working as hard as we can to reduce any undue burden placed on you by UnitedHealthcare’s recent actions to disrupt your access to your ARC doctors.

We have heard from so many of you over the past few days and empathize with your worry and frustration about your access to health care through December 31, 2018. We have been part of the community and part of your lives since 1980 and we regard ourselves as part of your family.

We sincerely apologize for this inconvenience. We appreciate your trusting us with your most important asset, your health. We take that trust and responsibility very seriously and we would like to care for you and your family for many years to come.

 

In good health,

 

Anas Daghestani, MD Norman Chenven, MD
CEO, Austin Regional Clinic Founding CEO, Austin Regional Clinic

Tags: None