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Rita Landgraf, Secretary
Jill Fredel, Director of Communications
302-255-9047, Pager 302-357-7498
Date: March 13, 2014
NEW CASTLE (March 13, 2014) - The Delaware Division of Medicaid and Medical Assistance (DMMA) is extending the deadline for families who want to change their managed care organization because of a contract negotiations impasse between United Healthcare Community Plan and Nemours Health Systems.
Medicaid Director Steve Groff said the state will extend the special enrollment period from the previous deadline of March 14 to April 25. Families can request a transfer from United Healthcare to Delaware Physicians Care, Inc. - the state's other managed care organization - in order to preserve their children's providers at Nemours' A.I. duPont Hospital for Children. Groff said that transfer requests made after March 21 won't take effect until May 1.
Through Delaware's Medicaid and Children's Health Insurance Program (CHIP), more than 33,000 children had been served by United Healthcare. As of March 12, Groff said 3,183 families, representing 5,744 children and 1,022 adults, had made the change to DPCI.
Groff said DMMA wants to ensure that all families have the opportunity to fully consider their options in order to make a choice that best suits the needs of their children.
"The steady high volume of transfer requests indicates that more time is needed for families to consider all available options and make a decision as to how best to meet the needs of their children," Groff said. "Therefore, we will be extending the special enrollment period until April 25, 2014."
After the special enrollment ends, Groff said requests from families with children who are receiving care from Nemours providers may be approved by DMMA if "good cause" can be demonstrated that the transfer is necessary to ensure continuity of care.
"This extension is about ensuring that there is no disruption in medical services for Delaware children served by our Medicaid and CHIP programs," said Delaware Health and Social Services Secretary Rita Landgraf. "This extension will give Delaware families even more time to consider what is best for their children's health care."
In February, the state sent notices to all families covered by United Healthcare to alert them that the contract negotiations between United Healthcare and Nemours had reached an impasse. At the time, families were informed that they could decide to stay with United Healthcare and their children would be served by other medical providers, or they could request a transfer to Delaware Physicians Care in order to keep their providers at Nemours.
If families have questions or want to request a change from United Healthcare to DPCI, they can call Medicaid's Health Benefits Manager at 1-800-996-9969. Hours are: 8 a.m. to 6 p.m. Monday through Thursday, and 8 a.m. to 5 p.m. Fridays.
Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.