UHC: Network dermpath labs will be paid less starting Jan. 1

7/20/2021
From the ADA: UHC clarifies that network dermatopathology labs will remain in-network but paid less beginning Jan. 1
In a July 1 meeting, UnitedHealthcare (UHC) shared its plans with the American Academy of Dermatology Association (AADA) to change the Designated Diagnostic Provider Program (DDP) from a covered–vs–noncovered plan design to a tiered benefit plan. UHC also plans to delay full implementation of the program until Jan. 1, 2022.

From the AAD: In a July 1 meeting, UnitedHealthcare (UHC) shared its plans with the American Academy of Dermatology Association (AADA) to change the Designated Diagnostic Provider Program (DDP) from a covered–vs–noncovered plan design to a tiered benefit plan. UHC also plans to delay full implementation of the program until Jan. 1, 2022. These changes follow pressure from the AADA, several medical and health care societies, and state insurance commissioners for UHC to be more transparent with its network of diagnostic providers and selection criteria. While the tiered benefit plan means that DDP-approved labs will be paid higher than those that are not approved to participate in the DDP, this allows all UHC network dermatopathology labs to remain in network. UHC has assured the AADA that it is not expecting labs to experience any immediate referral disruptions or payment adjustments, and it intends these changes to only impact non-physician office labs. AADA will continue to monitor the changes to the program to ensure appropriate access to dermatopathology services. Visit the UHC provider website as UHC continues to identify which labs will be accepted into the DDP program. Contact the AADA at [email protected] if you’re experiencing issues with DDP