UnitedHealth Group Concedes Nearly 11,000 Medicaid Children

[slipslidingaway]

Enrolled With The Company In Maryland Have Not Seen A Dentist In 4+ Years; Few Dentists in Company’s Network Actually Serve Children

http://kucinich.house.gov/News/DocumentSingle.aspx?DocumentID=76943


"Washington, Oct 23 - After publicly disputing a Congressional Committee’s finding of thousands of Medicaid enrolled children in Maryland who were not getting dental care to which they were entitled, UnitedHealth Group conceded the accuracy of that and other findings made by the Domestic Policy Subcommittee, Oversight and Government Reform Committee, in a letter the company sent to Chairman Dennis Kucinich (D-OH).

“We have reviewed the October 2 letter, and we concur with the Majority staff’s findings,” the UnitedHealth letter states.

Following a seven-month investigation into the death of 12-year old Deamonte Driver, who died of a brain infection caused by tooth decay, and the review of thousands of records produced by United HealthCare, the Domestic Policy Subcommittee issued findings in an October 2, 2007 letter to the Company.

The Subcommittee found that: 10,780 children had not seen a dentist in four or more consecutive years; few of the dentists claimed by UnitedHealth Group to be in their network actually provided dentistry to children enrolled by United; and that a single dental office provided more than a third of all dental care in Prince George’s County, where Deamonte Drive lived and died.

“United’s admission proves what the Subcommittee has been saying all along. Medicaid-eligible children in Maryland do not receive the dental care to which the law entitles them and for which taxpayers pay,” Kucinich said. “This Subcommittee will continue its investigation into dentistry for Medicaid-eligible children.”

The Subcommittee’s majority staff investigation into the adequacy of access to dental care for Medicaid-eligible children in Maryland raised serious questions about the quality of United’s network of providers and the reliability of the lists the company publishes for use by its enrollees. The staff’s experiences indicate the real difficulties parents and guardians experience in identifying a general dentist to sever Medicaid beneficiary children.

The Subcommittee requested and evaluated documentation of United’s dental network and records of the claims submitted for services rendered to United beneficiary children in 2006.

For a full copy of the Domestic Policy Subcommittee’s findings and to view the correspondence between Chairman Kucinich and UnitedHealth Care, go to the Subcommittee’s Web site."

[LiberalVoice]

1. I have United Health care through my work and they suck. nt

[slipslidingaway]

3. We had them through work a few years ago and they were OK,

although in honesty we never really tested the system very much.

[DaveJ]

2. I finally watched Sicko the other day

Sorry but after seeing that movie, I don't care if health insurance companies sink or swim. Anyone who denies claims to people in need or even WORK BESIDE them doesn't deserve their job.

We have enough problems to worry about... if someone needs medical attention they should be able to walk into a doctor's office and get it. Period. These days, if someone is sick, the health insurance companies will take everything you own, every penny you have, and then after it's all gone let you die. It's the worst situation imaginable and it needs to be fixed.

[slipslidingaway]

4. Agree, but it is nice to see UNH concede that the committee's

findings are accurate after saying that they were not.

I do not know how the fee structure works between UNH and the government and it sounds as if the taxpayers are paying for care for these children, listing dentists in their network that do not provide care to children. :shrug:

"The Subcommittee found that: 10,780 children had not seen a dentist in four or more consecutive years; few of the dentists claimed by UnitedHealth Group to be in their network actually provided dentistry to children enrolled by United;"


Saw SICKO when it came out, our insurance company recently dropped the co-pays ($10) for a doctor's visit but added a $2000. yearly deductible...after raising our monthly contributions of course. Maybe we would average 8 visits a year, $80, so it is a significant hike :(

[DaveJ]

5. A similar situation...

A coworker mentioned to me yesterday that when he took his kids to the dentist, his dentist said that our insurance covers exams but not the actual dental work. So the dentist refused to do work they knew they would not be paid for. Maybe the UHCG situation is similar.

It's disgusting that a company will scam people into thinking they have real coverage, only to later find out they only cover exams.

[slipslidingaway]

10. I know our plan is paying less while our monthly payments rise.nt

[Raejeanowl]

6. United Health Care (Medicaid Version) Sucks Big-Time

My disabled brother had it while under Medicaid in Maryland. The coverage is slightly different for adults, but the horror stories and incompetencies are all the same. I'm surprised they say the dentists on the list don't serve children because despite having been given a legitimate written referral from UHC for adult oral surgery, we were told far after the service was rendered that adults were not covered in the plan, only children. We kept being referred verbally to dentists who were only pediatric-we never got to the do you accept UHC part.

The poor dentist in my brother's case, authorization in hand (doctor kept faxing and UHC kept "losing"), is probably still waiting to get paid. Otherwise, there was just constant fighting to get anything UHC says they provide. Their network booklets and website lists are a total, outdated joke. What few providers were still willing (we kept hearing they were dropped by doctors due to slow or no claim payment)to accept UHC wouldn't accept new patients. You'd have to travel 50 or more miles to see a doctor, no exaggeration.

[slipslidingaway]

11. All the more reason to cut out the middle men profit takers, there

has to be a better way to care for our people :(

[Toots]

7. From what I have been told most Dentists will not accept Medicaid patients

Period....

[Horse with no Name]

9. and if they do

They do such crappy work that it has to be redone.
In Texas, if a child has their teeth cleaned by a Medicaid dentist, it amounts to having a dental hygienist brush their teeth.

[slipslidingaway]

12. It sounds as if the government pays a provider for insurance

then when people try and use the services they run into problems. Again I do not know how the payment system works between the government and insurance companies for Medicaid patients.

[Wiley50]

8. According to Hartmann, William McGuire, United's head took $1.5 Billion

in compensation last year (salary plus stock)

I have adult medicaid in TN and they cover NO dental.

One of these days my tooth infections will kill me

[slipslidingaway]

13. Not covering dental basically says your teeth/mouth are not

part of your body :shrug:

Here's an article about the compensation...

UnitedHealth's Options Scandal Shows Familiar Symptoms
http://www.washingtonpost.com/wp-dyn/content/article/2006/10/17/AR2006101701467.html


"Consider the case of William McGuire, who over the past 15 years has transformed UnitedHealth from a struggling regional insurer in Minnesota into the second-largest health insurer in the country, largely through acquisitions of companies like Mid Atlantic Medical Services of Rockville. One in six Americans is a UnitedHealth customer. Under McGuire's leadership, the company's market value has risen to $60 billion. During that same period, he amassed stock options more valuable than those of any chief executive in history: $1.5 billion.

Even by today's standards, McGuire's compensation has been obscene. The big change came in 1999, when, in negotiations over a new contract, he demanded a pay package that would give him 2 percent of UnitedHealth shares. Significantly, McGuire insisted that he alone get to decide the timing of those options. And he wrote in a provision that he could be fired only upon a felony conviction, or failure to rectify a serious problem after repeated notices from the board.

The board of directors that agreed to such a lavish, one-sided contract included several luminaries: Tom Kean, the former governor of New Jersey and later chairman of the 9/11 commission; James Johnson, the former chief executive of Fannie Mae who created the culture that led to that company's costly accounting scandal; Gail Wilensky, a respected health-policy expert who once ran the Medicare and Medicaid programs; and former vice president Walter Mondale..."