United Healthcare Community Plan, the Healthcare Plan that is Shutting Down Our Community’s Doctors

Popular medicaid healthcare plan, the United Healthcare Community Plan which is used by most of the frum community, has slashed doctors reimbursement rates in NYC, making the plan unusable, and puts our physicians in danger of closing down.

by CrownHeights.info

A sudden and unexpected change in the medicaid based United Healthcare Community Plan has left the Frum communities pediatricians receiving almost no monetary compensation, putting them in danger of closing their doors.

A Pediatric Doctors office told CrownHeights.info that for a while they have been “biting the bullet,” making no money and only staying open to help their patients. This is the case with most of doctors in Crown Heights.

The problems began over the summer of last year, when United Healthcare sent letters to many Frum doctors offices informing them that they would no longer be “in system,” and would not be able to receive reimbursements for treating those using the Community Plan.

A flurry of negotiations ensued, and ended with an uneasy agreement.

Now, with only a few weeks warning, the plan told the doctors that despite their past agreement, they would be reimbursed at a rate barely half of what they were paid previously.

The rate change was implemented through a negotiated contract with United Healthcare, one that is used by almost all Frum medical offices and Urgent Cares.

Assemblyman Simcha Eichenstein made an attempt to fix the pressing issue with a meeting between local Boro Park pediatricians and United Healthcare, succeeding in working out a deal between them.

The deal, despite its success, has come under harsh criticism as it only includes a few doctors offices, leaving all other community doctors out, and reducing the ability for the other doctors to negotiate.

A Williamsburg pediatrics office contacted by CrownHeights.info offered an easy solution to the problem. Other medicaid based insurance plans are available with similar benefits and better reimbursement rates, he told CrownHeights.info, including FidelisCare, and Blue Cross Blue Shield plans.

A Healthcare administrator in Crown Heights warned that the care that the Frum community has enjoyed, with doctors who know our families and are available 24/7, is in jeopardy. He called on all the Frum communities to come together to shore up the gaps in the insurance based healthcare system, that leave our Doctors in danger of closing down.

If you are on a medicaid or Obamacare plan, or are switching to a new plan, please contact your doctor to make sure it’s one that is desired by the doctor your family uses.