Thousands of physicians dropped from UnitedHealthcare’s Medicare Advantage network without cause have been granted 30 days to challenge their termination, thanks to a recent federal court ruling.
The ruling shot down the insurer’s request to toss out a lawsuit brought by two county medical associations in Connecticut and gives their members 30 days from Feb. 7 to initiate arbitration. The physicians, like thousands of others in at least 10 other states, previously had no recourse to address United’s mass terminations announced in the fall. The terminations were set to take effect Feb. 1.
The county medical associations were backed in court by 35 medical associations and physician advocacy groups that filed a friend-of-the-court brief. Among these groups were 11 state medical associations and the Litigation Center of the AMA and State Medical Societies.
United has called its dramatic network reduction an “optimization,” but the AMA and dozens of other medical associations have pointed to the problematic timing of the terminations, which took place during Medicare’s open enrollment. The move created confusion for patients trying to determine whether their physician would remain in network for 2014.
The terminations will disrupt long-established patient-physician relationships, interfere with existing referral networks and undermine emergency department coverage in many hospitals, the medical associations told the agency in a joint letter sent to the Centers for Medicare & Medicaid Services shortly after the network change was announced.
A similar case brought by the Medical Society of the State of New York has been filed in federal court.
