UnitedHealth Group may have to reimburse the U.S. Defense Department part of a $20.5 billion contract because military families have been experiencing long delays getting medical-care referrals from the company, Bloomberg reports.
The contract includes “provisions for the recovery of costs due to poor performance,” Tricare spokesman Austin Camacho said in an e-mail to Bloomberg.
UnitedHealth, the nation's largest insurer, took over responsibility on April 1 for the western region of the military’s health-care system, known as Tricare.
The Pentagon scolded the Minnetonka-based insurer last week over its Tricare handling.
Bruce Jasurda, a spokesman for UnitedHealth, says the delays were caused by referral requests that "far exceeded the norms."
“The increased volume was driven largely by people asking whether previously authorized referrals and authorizations were still valid, resulting in large numbers of duplicate referrals in the system,” Jasurda said in a phone interview with Bloomberg last week.
UnitedHealth hopes to have the issues resolved in about a month.
The Business Journal notes the Minnetonka firm waged a lengthy and costly battle to win the military contract from TriWest Healthcare Alliance Corp.
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