United has dropped some doctors in retainer practices

The plan claims that annual fees violate its contract, but other insurers are not taking as hard a stance.

By Karen Caffarini, AMNews staff. April 21, 2008.

UnitedHealthcare is dropping some physicians with retainer practices from its network, saying the annual fee they charge to patients pays for services included under United's standard physician contract.

The fee covers customized care such as a comprehensive physical, 24-hour access, house calls, and extended appointments -- services that physicians in retainer practices say traditional practices typically would not provide. Retainer practices often limit patient loads to 500 or fewer.

United spokeswoman Cheryl Randolph said the company believes "it's perfectly fine for physicians to have these types of practices." But she said that many retainer practice services already are covered, causing its members to pay more than the physician's contracted reimbursement rate.

United has recently dropped six doctors associated with Boca Raton, Fla.-based MDVIP, a national network of about 220 physicians in retainer practices.

John Burpeau, MD, a Houston internist and one of the dropped physicians, said his retainer fee covers care that a health plan would not pay for. Dr. Burpeau said he and his patients made claims through United only for sick visits.

While many of these physicians eschew insurance, some do accept it to keep patients they used to see in their nonretainer practices. Or, they will accept insurance from patients while the physicians are still contracted with plans, then drop it when the contracts expire.

Medicare has established that physicians may not charge a retainer fee for any service that is already covered under the program.