August 10, 2018
Area(s) of Interest: Payor Issues and Reimbursement Practice Management Public Payors
The UnitedHealthcare (UHC) Community Plan has issued notice that it will no longer provide services to approximately 4,400 Medi-Cal members in Sacramento County effective November 1, 2018. The exit from Sacramento County comes one year after UHC Community Plan first entered the Medi-Cal marketplace with participation in San Diego and Sacramento counties.
According to the notice mailed to Community Plan physicians in July 2018, the Department of Health Care Services will transition all UHC Community Plan members in Sacramento County to other participating Medi-Cal managed care plans by November 1. According to the Sacramento County Department of Health Services, the other currently participating Medi-Cal plans are:
- Aetna Better Health
- Anthem Blue Cross
- Health Net Community Solutions
- Kaiser Health Plan
- Molina Healthcare
Patients may also be able to continue to see their physicians, even if they are not contracted with the patient’s new delegated entity, under California’s continuity of care law. Under continuity of care laws, patients with an acute condition, serious chronic condition, duration of a pregnancy, duration of a terminal illness, care of children between birth and 36 months, or for the performance of a surgery or other procedure that has been authorized, may qualify to request continuity of care. UHC Community Plan members who wish to request continuity of care, need assistance in selecting an alternative Medi-Cal health plan or who have questions regarding transitioning to a new plan can call (800) 430-4263.
For more information on continuity of care requirements, see the California Medical Association’s Health Law Library document #7051, “Contract Termination By Physicians and Continuity of Care Provisions.”
Physicians with questions regarding the transition should contact UHC Provider Services at (866) 270-5785.