Connecticut’s Attorney General George Jepsen sent a letter Wednesday asking federal health care officials to “aggressively scrutinize” UnitedHealthcare’s decision to eliminate thousands of doctors from its Medicare Advantage network next year.
“… United has resisted providing this office with even the most basic information about the scope of its termination and its impact upon patients – namely, the number of doctors terminated from its network and the number of patients who, as a result of those terminations, will be forced to seek care with other doctors within United’s network or pursue different benefits options during open enrollment,” Jepsen wrote.
The letter was sent to Christie L. Hager, regional director of the U.S. Department of Health and Human Services, the agency that oversees the Center for Medicare and Medicaid Services.
Cutting hundreds or thousands of doctors from an insurer’s physician network is unprecedented in any context in Connecticut, lawyers for Jepsen said in a phone interview Thursday.
“We are deeply troubled by United insisting that its remaining provider network will be adequate despite simultaneously claiming not to know the number of patients affected,” Jepsen wrote.
News that UnitedHealthcare will cut doctors from its Medicare Advantage network next year was first revealed by the Fairfield County Medical Association in early October. The insurer is cutting 810 primary care physicians and 1,440 medical specialists across Connecticut, which is 19 percent of its network, according to the medical association. UnitedHealthcare has not said how many doctors have been cut from its network, but the insurer says the remaining network is adequate.
Two weeks ago, Connecticut’s congressional delegation — five congressmen and both U.S. Senators — wrote to UnitedHealthcare Medicare & Retirement CEO Jack Larsen asking for answers about when doctors and patients were notified of the changes.
UnitedHealthcare spokeswoman Maria Gordon Shydlo said Wednesday the insurer is working with the Centers for Medicare & Medicaid Services and Jepsen’s office “to help address the needs of local providers and members and further explain the changes we are making to our Medicare Advantage network.”
“We understand that these changes, while necessary, will be disruptive for some members,” Gordon Shydlo said in a prepared statement. “Supporting our customers is our highest priority in this process. We are ready to help them understand their options, and we are working to ensure this does not disrupt care they may currently be receiving.”
Jepsen said in a phone interview that UnitedHealthcare is overstating its efforts by saying that it is working with the attorney general’s office. The insurer hasn’t provided basic information about how many patients are affected, he said.
UnitedHealthcare has about 58,000 Medicare Advantage customers in Connecticut, though it’s not clear how many of them will no longer be able to see their primary care physician or a medical specialist at in-network rates. Customers also have the option of switching to a different Medicare Advantage carrier or sticking with standard Medicare for medical and hospital coverage, though standard Medicare typically has higher out-of-pocket expenses than Medicare Advantage.
UnitedHealthcare is one of a number of insurers that offer Medicare Advantage plans in Connecticut and across the nation. Medicare Advantage plans are a type of federal-government-funded health-care plan offered by private insurers to people age 65 and older. Insurers contract with the federal government to provide Medicare Parts A and B, which is hospital and medical coverage, respectively. A Medicare Advantage plan may also provide additional coverage, such as prescription drug benefits.
UnitedHealthcare has yet to notify patients affected by the change so they can make necessary decisions during the open enrollment period for Medicare Advantage, which ends Dec. 7, Jepsen wrote in his letter. He also said some physicians are just now learning that they have been terminated from the network in letters dated Oct. 31.
Jepsen’s office does not have the authority to resolve the matter because Medicare Advantage is a federally administered program.
Jepsen asked federal officials to determine how many Medicare Advantage customers are affected and the number of physicians affected. He also asked that the open enrollment period be extended so that customers can make informed decisions about their health plans.
The Centers for Medicare and Medicaid Services said it is reviewing UnitedHealthcare’s provider network to “ensure it continues to meet Medicare’s provider network requirements.” The federal agency also said it will “closely monitor complaints from beneficiaries to ensure they have access to needed care.”
The Fairfield County Medical Association is hosting a town hall meeting to discuss the potential consequences of the network changes and to talk about what can be done “to reverse the decision by UnitedHealthcare.” The meeting is 10 a.m. to noon Saturday, Westport Town Hall Auditorium, 110 Myrtle Ave., Westport.
UnitedHealthcare said it encourages any of its customers to call its customer service division for assistance, at 888-332-8883.