Court Order Expires; Doctors Dropped From UnitedHealthcare Medicare Advantage Network

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A temporary court order preventing UnitedHealthcare from dropping doctors affiliated with medical associations in Fairfield and Hartford counties has expired and those physicians are out of the insurer’s Medicare Advantage network as of March 11.

Despite the doctors’ out-of-network status, the health insurer is extending in-network benefits with those physicians through April 30. The insurer is planning to notify its members of the change by mail.

“To support our members and minimize potential confusion we are extending in-network benefits with providers previously covered by the injunction through April 30th,” UnitedHealthcare spokeswoman Jessica Pappas said in a statement. “We encourage members with questions regarding their physician’s network status to contact customer care at 1-888-332-8883.”

UnitedHealthcare notified doctors last fall that it planned to reduce its physician network by thousands of doctors in Connecticut. The insurer has never said how many doctors it planned to cut, but the Fairfield County Medical Association said it is 810 primary care physician and 1,440 specialists across the state.

Fairfield County Medical Association and Hartford County Medical Association filed a lawsuit against UnitedHealthcare last fall in U.S. District Court in Bridgeport. The case was appealed to the 2nd U.S. Circuit Court of Appeals in New York, which modified a temporary injunction issued by the Bridgeport court halting UnitedHealthcare’s plans to cut doctors.

The appeals court gave the aggrieved doctors up to 30 days from Feb. 7 to challenge their removal from the insurer’s network through arbitration.

“Even though the 30-day period has run out, the physicians still have one year from the date that they received the termination notice … to go to arbitration,” said Mark Thompson, executive director of the Fairfield County Medical Association.

The association has heard from several dozen physicians want to arbitrate UnitedHealthcare’s decision to cut them. Those doctors have to take their case to the American Arbitration Association — a group known by the acronym AAA, not to be confused with the American Automobile Association.

“So many people have stepped up that they jammed up the AAA office. They put them on overload. They said, ‘We can’t handle all this,’” Thompson said. “We had to work out an arrangement with United[Healthcare] and AAA so that anyone who wanted to arbitrate had time to do it.”

Check back for more on this story throughout the day.

About Matthew Sturdevant

Full-time staff journalist at The Hartford Courant and magazine freelancer with a master's degree in writing from Dartmouth. My work has appeared in The Los Angeles Times, The Chicago Tribune, Taiwan News, The Baltimore Sun and many other news sources. My blog has been referenced by Politico.com, the Kaiser Family Foundation, the Georgetown Law Library and a number of organizations in healthcare and business. Sturdevant’s blog is "a well-written wealth of ideas," said The Donald W. Reynolds National Center for Business Journalism, (businessjournalism.org, May 18, 2011). I have experience writing for newspapers, magazines, Web sites and blogs as well as shooting and editing video. I made regular appearances on news-talk radio and on the NBC affiliate station in Corpus Christi, Texas. I made occasional appearances on the Fox affiliate in Connecticut promoting Hartford Courant articles.

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