Public Announcements

 

We need your help!

The leadership within the state associations of physical therapy, occupational therapy and speech language pathology continue to meet and discuss with UHC Community Plan (UHCCP) leaders about the recent implementation of a pre-authorization process for Medicaid beneficiaries.    Our goal with these meetings has been to successfully advocate for timely and clearer explanations of the prior authorization process and to advocate for change in their policies.  Recently, we have also included the Nebraska Medical Association in our meetings as the physicians in Nebraska are not in favor of the new authorization process either.    The prior authorization process has delayed care for medically necessary services and puts unnecessary administrative burden on therapists and physician practices alike.   

We have not been successful in removing, nor streamlining the pre-authorization process.  The first step in this arduous, two-step process is to have the patient see his or her MD.  The MD must then enter a request formally with UHCCP.  This request is only for a PT evaluation.  UHCCP then has up to 14 days to authorize or deny the MD's request. The PT then completes his or her evaluation without providing any treatment.   The next step is for the PT to fax the plan of care to the referring MD.  The MD then approves this and faxes it back to the PT.  The PT then must enter the plan of care, as well as attach it to the request with UHCCP.  Finally, UHCCP then has an additional 3 – 14 days to approve the treatment plan at which time you may treat the patient.

At this time, we believe our next step should be to inform the public through media sources the impact that the prior authorization as well as other policies affect the Medicaid beneficiary.  WE NEED YOUR HELP!   

We need personal stories about patients that had a negative consequence because of the prior authorization process.  In addition, we need the impact that this has had on the therapist and clinic - the hoops and hurdles the clinic had to do in order to provide the needed services to the beneficiary. Please send these stories to Brian Brunken at [email protected]

In addition, If you have a case illustrating these issues and the patient/beneficiary/family and yourself/clinic would be willing to talk to a media source, please fill out the information below.   We would like to get them from across the state to show that this is TYPICAL and widespread.  

Please send your stories following this format:

 

Beneficiary’s Name:

Contact Information:

Brief description of the impact the prior authorization had on this person:

Clinic Name:

Person to contact at Clinic:

Contact information of the above person:

Brief description of the impact (financial, emotional, stress) had on the clinic/therapist:

 

Please send your stories to Brian Brunken at [email protected]