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Physicians, Patients Upset with UnitedHealth’s Decision To Drop Docs

by | Oct 11, 2013 12:50pm () Comments | Commenting has expired | Share
Posted to: Town News, Bridgeport, Fairfield, Health Care

istockphoto Just two weeks before open enrollment, UnitedHealth Group’s decision to drop doctors from its Medicare Advantage network has doctors and patients upset and confused.

Last week, physicians received letters from UnitedHealth informing them that they had been “terminated without cause,” effective February 1, 2014, according to the Fairfield County Medical Association and Connecticut State Medical Society. But it’s still unclear exactly how many doctors were affected by the decision.

A UnitedHealthcare spokesman declined to answer questions about how many doctors may be impacted by the decision.

“We offer our members one of the most extensive networks of health care providers in Connecticut and remain committed to ensuring they have continued access to quality, affordable care,” Ben Goldstein, a UnitedHealth spokesman for the region, said Thursday in an email. “Members with questions are encouraged to call the customer service number on the back of their member ID card for more information.”

Mark Thompson, executive director of the Fairfield County Medical Association, said Friday that patients are calling the insurance carrier, but the answer they get depends on what time of day they call. He said he’s spoken to patients who called in the morning and were told their doctor was on the plan, but when they called back in the afternoon the doctor was off the plan.

“There’s mass confusion,” Thompson said. “Even the company doesn’t know what’s happening.”

A patient who has six months to live called yesterday in tears because she was told she will have to find a new oncology doctor, Thompson said, adding, “Can you imagine?”

He said UnitedHealth needs to stop this and rescind the letters until it knows what’s happening.

The doctors who received the letters serve some of the sickest patients, many of whom suffer from four or more chronic conditions. One of the largest dialysis groups in Bridgeport received notification that they will no longer be able to accept UnitedHealth’s Medicaid Advantage, which will force patients to go to New Haven or Long Island, New York. Thompson said the equation used to calculate the nearest facility apparently doesn’t take into account a body of water called the Long Island Sound.

For the average patient, driving an extra five miles for care can be an inconvenience, representatives of the Connecticut State Medical Society said Thursday in a release. For seniors with limited mobility, those same five miles can be a significant barrier to access.

“The timing is questionable,” CSMS President Dr. Michael F. Saffir, said. “This comes less than two weeks before Medicare’s Open Enrollment period — how can seniors make informed decisions when their own doctors don’t even know whether they’re in the United network?”

Open enrollment for the programs begins Oct. 15 and runs through Dec. 7.

Thompson said he understands that UnitedHealth is doing this to manipulate their “profitability by controlling their network,” in order to raise its rating under a new five-star system established under the Affordable Care Act. But “it’s a step in the wrong direction,” he added.

The Fairfield County Medical Association and the Connecticut State Medical Society said UnitedHealth has refused to tell them which doctors received notices and even some of the doctors who did receive notice may still be in the UnitedHealth Medicare Advantage network. They also refused to tell the organizations what criteria they used in kicking doctors out of the network.

Both organizations have been in touch with federal officials, Medicare advocates, and lawmakers since the news broke last week.

Medicare Advantage plans cover Medicare Parts A and B. They are funded by the federal government, but administered by private insurance companies who attract customers by offering other cost protections not available under traditional Medicare.

Thompson said that because these insurance carriers are administering a public program, there’s a “moral” responsibility that they have to be good corporate citizens.

“They are stewards of a public health care program,” Thompson said.

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(3) Archived Comments

posted by: Noteworthy | October 11, 2013  6:33pm

United Healthcare’s decision is disturbing and beyond troubling. It is a clear indication that United can’t be trusted with our healthcare. Companies should consider dropping this company. It is without conscience that they drop this on people at the last moment and blaming it on Obamacare. Anthem dropped the coverage to people with high deductables last week instead of amending the policies and repricing to bring into compliance. The insurance state is turning into the ripoff state - this time from the insurance companies.

posted by: lkulmann | October 12, 2013  7:30pm

UnitedHealthcare is AARP endorsed so they may know the scoop. I can assure you its about the bottom line. In business its ALWAYS about the bottom line. Second thought is the docs of the more chronically ill have been dropped. The more ill the more expensive. CT doesn’t like to pay for the sickly expensive patients. They tend to cut too many services for the ‘non productive’ citizens.  Insurance companies are being set up for lawsuits.  This isn’t the first insurance company to drop CT for the same reasons. Plus docs are incentivized by cutting corners saving CT $$$. Maybe The Healthcare Advocate will start advocating for CT’s chronically ill but I know for a fact that is unlikely. Being self insured doesn’t mean you can take care of only the patients you want. You have to take care of them all…EQUALLY

posted by: edvolpintesta md | October 14, 2013  4:23pm

October 11, 2013
Connecticut NewsJunkie.com

That United Healthcare has dropped state doctors from the Medicare Advantage plan shows how a powerful insurance company can make a unilateral decision that drastically affects the way medicine is practiced.

UnitedHealthcare’s dropping of over 2,000 physicians from its Medicare Advantage plan shows a heartless disregard for patients’ safety and peace of mind.  This is a particularly difficult problem for the elderly. For many of them will have to find a new doctor to replace the one that they had.

Maybe UnitedHealthcare doesn’t think that switching doctors is a big deal but it takes years to build a trusting relationship with a doctor and if it is taken away, it is not replaced by simply looking in the phone book for another doctor.

Many patients who have serious illnesses like heart failure or cancer are elderly and their health is in a delicate and fragile balance. Making them start all over with another physician can have serious consequences for their future health.

Moreover, because many seniors consider their physicians their friends and confidants, breaking that special connection can cause needless anxiety and even depression.

Clearly, United Healthcares’ dropping physicians is a misguided action with serious consequences for the most vulnerable members of our society, many of whom not only have chronic diseases but an increasing number of whom are homebound and some of whom don’t even know how to go about finding a new doctor.

Our lawmakers need to protect the elderly against being exploited by the powerful health insurers.  If our lawmakers do not denounce UnitedHealthcare for placing the elderly at risk, their indifference will encourage other insurers to exploit the elderly as well.

Edward Volpintesta MD

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