UnitedHealthcare drops physicians from Medicare plan

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Physicians across the state are reeling after they were informed that they will no longer be participants in a popular Medicare program.
UnitedHealthcare sent a letter dated Oct. 2 to 810 primary care physicians and 1,440 physician specialists, telling them that the separation from its Medicare Advantage network would be effective Feb. 1, 2014.
The business, a unit of Minnetonka, Minn.-based UnitedHealth Group, said affected physicians have the right to appeal and told them that their agreements for other UnitedHealthcare networks will not be impacted.
The notification came as a surprise to the Fairfield Medical Association, which counts 1,499 physicians in its ranks.
“They’re letting 19 percent of the physicians in the network go,” said Mark Thompson, executive director of the association. “This is where insurance companies are using insurance contracts to interfere with the doctor-patient relationship.”
UnitedHealthcare’s one-page letter, signed by Jenny Hayhurst, vice president, network management, was perfunctory.
“Given the significant changes and pressures in the health care environment, we have undertaken a review of our network and are making changes to its composition,” read the letter. “As a result, UnitedHealthcare is amending your agreement referenced above to discontinue your participation in the Medicare Advantage network effective on February 1, 2014.”
It is one of several Medicare programs offered by UnitedHealthcare.
In an emailed commentary, UnitedHealthcare spokesman Benjamin Goldstein said the company is building a network of health care providers to have the most positive impact on the quality of care for its members.
“This will encourage better health outcomes and ultimately lower costs,” he said. “We are notifying affected UnitedHealthcare members and are taking steps to help them transition to new providers. Members enrolled in our commercial, Medicaid and Medicare supplement plans are not impacted by current changes to the Medicare Advantage plan network in Connecticut. Our analysis of network changes is ongoing as we continue dialogue with local care providers.”
UnitedHealthcare is working with health care providers in Connecticut to meet the needs of its Medicare Advantage members, Goldstein said.
Thompson was unable to say how many physicians in the 1,499-member regional chapter will be affected by the decision.
“This is very significant. This has the potential to cause severe problems for access to health care,” Thompson said, predicting that it will result in longer wait times for medical appointments with the remaining physicians on the company’s approved list. “This is going to send shock waves through communities. United is trying to improve its profitability levels. It does make you question for-profit insurance companies when companies can make decisions like this in a vacuum.”
One of those medical practices that received a letter is Nephrology Associates in Bridgeport, which specializes in kidney dialysis procedures.
“This is the first time we’ve been de-listed from a health network,” said practice manager Cindy Lovejoy, who has been with the Nephrology Associates for 26 of its 35 years. “We were terminated without cause.”
The decision will severely inconvenience about 36 patients, some of whom are in fragile condition, according to Lovejoy, who said the practice serves more than 500 patience at dialysis units in Bridgeport, Fairfield, Milford and Shelton. “This is really devastating for the patient. There’s not much of a choice for them to go for dialysis. It’s a very dangerous situation.”
Those affected patients will have to find another dialysis practice that accepts United Healthcare’s Advantage coverage or change to another provider.
UnitedHealthcare is dedicated to helping people live healthier lives by simplifying their health care experience, meeting consumer health and wellness needs and sustaining trusted relationships with care providers, according to information on its website, which said it has direct contracts with more than 650,000 physicians and care professionals and 5,000 hospitals.
Publicly traded on the New York Stock Exchange under the ticker symbol “UNH,” it serves more than 38 million people.

Categories: General

3 Responses

  1. Veritas says:

    Isn’t United one of the largest medicare advantage providers in the State?
    What is the Ct. Insurance Department going to do about this?
    Meanwhile, United is merrily $pending on t-v commercials with AARP promoting its plans!

  2. carole white says:

    I would rather change health insurance provider, United Heath Care, than change the doctor I have been with for 16 years. Money talks, so the doctors in Florida were told to take a “walk.”

  3. Edward Volpintesta MD says:

    It is unconscionable that UnitedHealthcare has dropped over 2,000 doctors from its Medicare Advantage network as reported in “UnitedHealthcare drops doctors form Medicare plan” (Oct. 9).
    A shortage of physicians already exists and by their misguided decision, UnitedHealthcare makes the situation worse.
    This is just another example of how susceptible our health system is to becoming depersonalized when it is left in the hands of private insurers whose main interest is in preserving profits for stockholders.