UnitedHealth said to use secret rules to restrict rehab care, STAT reports

UnitedHealth used secret rules to restrict access to rehabilitation care requested by specific groups of seriously ill patients, including those who lived in nursing homes or suffered from cognitive impairment, STAT’s Bob Herman and Casey Ross report, citing internal documents obtained by the publication. The documents, which outline parameters for the clinicians who initially review referrals for rehab care, reveal that many patients enrolled in Medicare Advantage plans were routed for a quick denial based on criteria neither they, nor their doctors, were aware of. UnitedHealth kept the restrictions in place until early November, when managers abruptly told frontline clinical reviewers to stop following them and apply more of their own discretion, according to a current employee and internal documents.