A federal appeals court is hearing arguments Tuesday about whether an injunction preventing massive terminations of physicians from UnitedHealthcare’s Medicare Advantage plan should remain in effect.
The injunction, granted by a district court in a case brought by two county medical associations in Connecticut, prevents the insurer from terminating the more than 2,000 physician members of these associations who had been told they would be dropped from its Medicare Advantage network effective Feb. 1.
United—the nation’s largest Medicare Advantage insurer—has appealed the order, claiming that it represents a greater hardship for the insurer than the physicians affected by it.
Backing the two county medical associations are 35 medical associations and physician advocacy groups that have filed a joint friend-of-the-court brief, including the Litigation Center of the AMA and State Medical Societies, 11 state medical associations and multiple medical specialty societies.
“United’s administrative concerns are greatly outweighed by the very real harm that would be caused by the disruption of the physician-patient relationships and the harm to these patients’ care which would result without the protection of the injunction,” the brief states.
The physician groups are arguing that the district court got it right when it found that the terminations would cause irreparable harm because the “financial imperative” of paying significantly more for out-of-network care would prevent patients from continuing treatment with their current physicians.
“[T]his is particularly problematic for the elderly and disabled patients enrolled in Medicare Advantage plans, who tend to suffer from chronic and often life-threatening conditions for which continuity of treatment is critical,” the associations state in their brief.
In addition to the Connecticut physicians affected by this case, tens of thousands of physicians in at least 10 other states have been identified for removal from United’s Medicare Advantage plan networks.
Other implications of these network changes include disrupting existing referral networks and undermining emergency department coverage in many hospitals, the AMA and more than 80 other medical associations pointed out in a November letter urging the Centers for Medicare & Medicaid Services to take action.
“United’s conduct, if not enjoined,” the brief states, “would have devastating effects.”
