MSDC has spoken with Karen M. Johnson, the Executive Director at UnitedHealthcare Community Plan about the status of the Medicaid fee schedule recoveries.

  Ms. Johnson said:

"We value our partnerships with the medical community and recognize that the recent events related to the changes in the District's Medicaid Fee Schedule have caused frustration for many. We apologize for any difficulty this has caused and effective April 25, 2012, UnitedHealthcare Community Plan ("United") suspended recoveries for claims United overpaid due to the 20% reduction in the District's Medicaid fee schedule. If you have already paid United based on a letter and 1/1/11-10/31/11 claims detail you received from its Recovery Services, United will refund these payments to you within the next thirty (30) to 45 business days. United is planning a Provider Town Hall here in the District for the week of May 21 to discuss the status of its Medicaid fee schedule implementation. You will receive a invitation directly from United in the very near future."

This message will be posted today to UHC's website at www.unitedhealthcarecommunityplan.com. If you have questions regarding UnitedHealthcare Community Plan, please call their recovery team at 1-800- 727-6735 ext. 77376.

     As CMS has indicated late last week, although there is no formal appeals or review process for the e-prescribing penalty, they encourage  physicians with questions or concerns about their penalty and / or hardship exemption request to contact CMS' QualityNet Help Desk as soon as possible. CMS is handling all penalty and / or hardship exemption requests and any questions or concerns on a case-by-case basis.  

     Physicians should continue to contact the QualityNet Help Desk if they have issues relating to the e-prescribing penalty.  If a physician has previously contacted the QualityNet Help Desk and their case has been resolved to their satisfaction, the physician does not need to contact the QualityNet Help Desk again. 

     The QualityNet Help Desk can be reached M-F; 7:00 am - 7:00 pm CMT at 866-288-8912 or via email at qnetsupport@sdps.org.     NOTE:  If a physician continues to experience problems with the Help Desk, CMS is encouraging physicians to email their concerns directly to Medicare at eRx_hardship@cms.hhs.gov.