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United Healthcare Referral Algorithms Not Working Well With Tri-Care, Company Moving Their Subsidiary Execs Around, DOD Could Fi

Posted Jun 12 2013 3:05am

This company has more subsidiaries than Carter has pills.  Due to doctor and patient complaints on referrals, the DOD is keeping a close watch and United said they are getting things in order.  Well moving a CEO from one subsidiary to another should do it, right..not really it’s the automated algorithmic processes that need to work but to show they were addressing the situation they moved people around.  I was not aware of the UnitedHealthcare Military & Veterans Inc. that was created just to go after Tri-Care contracts..and they did..they sued the government in a long drawn out affair for the west after they lost the bid on the south portion of the Tri-Care area of the US.  If you read more about the LHI subsidiary maybe this had something to do with the lawsuit as it also is contracted to the military and the VA and they wanted LHI and Tri-Care to work with both subs?

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?
UnitedHealth Loses Tri-Care Protest Again With Contract Awarded to Humana in the South-Now Protesting Contracts Awarded In Both the South and the Western States

The company is moving a person over from the LHI United Subsidiary over to the Military and Veterans subsidiary.  The LHI subsidiary of United conducts VA DEM imagedisability exams and is looking for more doctors to enroll in the program and they have a website set up to where the exam information is entered (one more thing for a participating physician to learn) and the results are populated directly to the VA records via the web service, so I guess this means that this subsidiary of United can populate a VA chart?  It sounds that way from what I am reading here.  So in addition to Tri-Care services, United also appears to be making money with the VA and other areas of the military with the LHI subsidiary in having a contract to help the VA catch up with their disability claims. 

From the website it appears the government is one of the main clients of LHI (or maybe the only one) as the company comes in and does an “event” on location for physicals, etc. for the military.  You can read more about this United Healthcare subsidiary and their services they provide to the VA here with their contract to provide clinical disability exams for the vets.   I swear this company with their subsidiaries is every where getting a part of the action and in the world of insurers, do we have a too big to fail company here?  The corporation has board members sitting around all over the corporate world too and some come from subsidiaries. 

“We have administered private occupational health services imagein support of various federal agencies including the Centers for Disease Control and Prevention (CDC), Federal Occupational Health Service (FOHS), Department of Defense (DoD) and the Veterans Health Administration (VHA). We support a wide variety of customers, including: National Institute for Occupational Safety and Health (NIOSH), U.S. Army Medical Command (MEDCOM), the Army Reserve, Army National Guard, Air Force Reserve, Air National Guard, Army Dental Command, Navy Reserve, Army Corps of Engineers, Coast Guard, Military Sealift Command and other Federal agencies. LHI also supports a number of private sector clients with occupational health services, including four of the Class 1 railroads operating in the United States.”

The military has given United another month to address the problems with the United Healthcare Military subsidiary and has until June 18th to clean things up or United could get yet another extension.  BD


UnitedHealth care Military & Veterans Inc. has changed leaders after encountering serious problems administering a new $20.5 billion federal contract to provide health care to active military members, retirees and their families in 21 states, including Minnesota.

Tina Jonas, a former undersecretary of defense now presiding over a UnitedHealth Group subsidiary called Logistics Health Inc., will take a newly created position of president at UnitedHealthcare Military & Veterans, said Bruce Jasurda, the company’s vice president of communications. The company did not name a CEO.

“We have substantially processed the pending referrals and authorizations, largely clearing the previously existing queue,” Jasurda said. “We are confident that we will continue to process referrals and authorizations after the June 18 waiver expiration in a timely manner consistent with DoD [Department of Defense] guidelines.”

UnitedHealth formed UnitedHealthcare Military & Veterans Inc. in 2007 specifically to go after Tricare contracts. McDougal, who has been working at UnitedHealth since 1983, was originally named chief operating officer. She became CEO in early 2008.

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