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  4. UnitedHealthcare Deadline Flexibility for Designated Provider Program

The CAP followed up with UnitedHealthcare leaders to discuss the insurer’s upcoming plan changes and the newly-announced Designated Diagnostic Provider laboratory program. While the February 28 deadline for laboratories to submit a quality questionnaire passed, UnitedHealthcare officials confirmed to the CAP that they would be flexible on that deadline, and CAP members can contact ddp_lab@uhc.com with concerns and questions.

UnitedHealthcare announced the new program impacting outpatient laboratory services for fully insured commercial members. Effective July 1, 2021, the insurer will only cover outpatient laboratory services for members when delivered by a “Designated Diagnostic Provider” laboratory. Laboratories that are not a “Designated Diagnostic Provider” will remain in-network, but outpatient diagnostic laboratory services will not be covered. UnitedHealthcare sent communications to all diagnostic providers to encourage them to become a Designated Diagnostic Provider by completing a quality questionnaire.

The CAP is continuing to engage with the insurer to ensure access to pathology and laboratory services across all settings. Visit the CAP’s private sector advocacy webpage for more information.

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