12/16/2020

UnitedHealthcare Accumulator Adjustment Program Delayed

Beginning January 1st UHC planned to begin their national accumulator program. Whether you participate in manufacturer financial assistance programs or not, you would have had extra reporting requirements beginning in January and money paid by a manufacturer copay card would not count towards the patient’s deductible or annual out of pocket maximum. 
 
Patients could be stuck paying high out-of-pocket expenses once copay assistance is depleted, leading to increased abandonment.

·      Providers & infusion sites would be impacted by the increased workload associated with identifying and reporting manufacturer assistance to UHC.
·      Manufacturers would have to weigh expanding their copay assistance program to minimize patient out-of-pocket expenses against capping programs, which could result in patients paying high out-of-pocket expenses and disrupting therapy.
 
After the initial announcement in October, UHC received countless letters signed by advocacy groups and professional associations and recently announced the delay of the program.  “The program will not take effect on Jan. 1, 2021 as previously communicated. We are delaying this program due to recent feedback we’ve received from healthcare professionals like you. “ 
 
The UHC policy would have placed providers in an ethically objectionable position by requiring they report information that would be used to harm patients by impacting their ability to access treatments or cause them to discontinue or switch treatments because they cannot afford the out of pocket expenses.
 
While the decision to delay is a win for patients and providers, it will be wise for stakeholders to monitor what UHC and other insurers decide to do in the future. 
 
Reference: CLICK HERE