Hackensack University Medical Group goes out of network with UnitedHealthcare

UnitedHealthcare has dropped coverage with Hackensack (N.J.) University Medical Group six months in advance of its exit from the state's Affordable Care Act market, according to The Record.

The decision comes after a midyear contract renegotiation, in which the group's 450 physician members failed to agree with UnitedHealthcare's United Compass plan. Only United Compass plans on the ACA market, excluding those sold commercially, are affected.

UnitedHealthcare said about 300 people will lose cover due to the change. Since the Compass plan does not allow out-of-network coverage, consumers have to change providers. A spokesperson from UnitedHealthcare issued an apology and told The Record the payer "will be sending out updated information on 'transition of care' benefits in the coming days to ensure they have what they need to access care."

Those who lost coverage will have to wait until Jan. 1 to purchase a new plan, as they do not qualify for special enrollment, according to The Record.

New Jersey requires payers to notify patients 30 business days in advance when their physician will depart from a managed-care network, according to The Record. In addition, the state requires insurers to provide coverage for four months if the patient is undergoing continuous and necessary care. 

Insurance plans can make midyear network changes lawfully. This was the case in 2013 when UnitedHealthcare dropped physicians in 10 states due to financial losses.

This article has been updated with a correction. UnitedHealthcare dropped the Hackensack University Medical Group. The Hackensack University Medical Center is still in network. 

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