NJ Medicaid Plans No Longer Contract with CHOP for Complex Patient Care

As of Dec. 1, 2020, New Jersey’s UnitedHealthcare Community Plan terminated its partnership with Children’s Hospital of Philadelphia (CHOP). This move affects about 12,000 New Jersey children – many of whom have complex medical conditions. As these families seek replacement health plans covered by Medicaid, many will discover no plan will provide the level of care, diversity of specialists and targeted therapy their child previously received at CHOP.

What CHOP is doing to help children

At CHOP, our Government Affairs team and many teams across the CHOP Care Network are working together to find solutions for these New Jersey families. Currently, there is no requirement in New Jersey that ensures Medicaid families have access to the specific pediatric care they need.

Companion bills 4688 and 3000 would require all N.J. Medicaid Plans to have robust pediatric network adequacy requirements, an approach that would get children the care they need, but not place any insurer at a disadvantage in the market.

NOTE: The bill does not specify that this care would be available and covered at CHOP, just that it would be available to New Jersey patients who use this Medicaid insurance.

What you can do to help

Call or write to N.J. Gov. Philip D. Murphy at 609-292-6000 or via the online contact form on his office’s website. Please feel free to use the following language in your letter and share it with your community partners:

“We ask that the Governor declare that, for the duration of the COVID-19 public health emergency and four months following its declared end, that no child’s healthcare team be disrupted. We’re concerned for families – like ours – that have been impacted by UnitedHealthcare Community Plan’s decision to terminate its contract with Children’s Hospital of Philadelphia.

“Please take action to protect our families and ensure our children continue to have access to crucial medical care during these difficult times.”

Call or write your state representatives toll free at 800-792-8630 or via the state legislature’s contact form. You’ll be asked to share your address so you can contact the representative(s) for your area. Please feel free to use the following language in your letter and share it with your community partners:

“We ask the New Jersey State Legislature support and pass Assembly Bill 4688 and Senate Bill 3000 to ensure that all children – including those with complex medical needs and conditions – continue to have access to timely and complete medical care. We ask this so no child’s healthcare team is disrupted for the duration of the COVID-19 public health emergency and four months following its declared end.

“We’re concerned for families – like ours – that have been impacted by UnitedHealthcare Community Plan’s decision to terminate its contract with Children’s Hospital of Philadelphia. Please take action to protect our families and ensure our children continue to have access to crucial medical care during these difficult times.”

Suggested talking points in your call/letter

  • Hello, my name is (insert name) and I’m a resident of New Jersey and live in (insert county and zip code). I’m (calling/writing) today to express my concern with the UnitedHealthcare Community Plan’s move to terminate its contract with the Children's Hospital of Philadelphia.
  • The termination risks the well-being of thousands of New Jersey children who rely on specialized or coordinated care found only at CHOP or a very small number of pediatric health systems.
  • Families like mine, who have children with complex medical needs, face enormous challenges and have no choice but to see multiple physicians, specialists, and sub-specialists. Providing barriers to this care is unconscionable. (Optional: insert more information about your child, their condition(s) and family.)
  • As of Dec. 1, families who had been seeing CHOP doctors for years now face a disruption in their care due to UnitedHealthcare’s termination. We need your help.
  • Currently, there is no requirement in New Jersey that ensures Medicaid families have the right access to the pediatric care they need, but Assembly Bill 4688 and Senate Bill 3000 could change this. These bills would require all New Jersey Medicaid Plans to have robust pediatric network adequacy requirements, an approach that will get kids the care they need, but not place any insurer at a disadvantage in the market.
  • I ask that you do everything you can to see that this legislation becomes law. Thank you for your time!

Still have questions?

Check out our UnitedHealthcare Community Plan Q&A page.


Next Steps