UnitedHealthcare terminating contracts with Medicare Advantage doctors

UnitedHealthcare terminating contracts with Medicare Advantage doctors

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ST. LOUIS (KTVI) – St. Louis physicians are protesting a decision by UnitedHealthcare. The health insurance provider is terminating contracts with certain doctors currently accepting Medicare Advantage patients.
The president of the St. Louis Metropolitan Medical Society predicts thousands of patients will be affected.

“The thing that is most sacred is the doctor patient relationship,” said Joseph A Craftt III, M.D. “This is in direct violation to those principles.”

Bob Hughes is a skin care patient whose doctor just informed him about the changes that go into effect September 1st. Hughes must now find another doctor or pay a more expensive out of network price. If he wanted to switch to another provider, he must wait until an open enrollment period begins later in the year.

“I need to see a doctor and this is not right,” said Hughes.

UnitedHealthcare says patients can apply for a continuation of coverage with an out of network physician for a short amount of time.

George Hruza, M.D. is the medical director for the Laser & Dermatologic Surgery Center in Chesterfield. He estimates nearly half of the area dermatologists have received termination notices from UnitedHealthcare regarding Medicare Advantage.

“If you put thousands of patients onto those remaining providers then I would imagine the waits are going to be even longer,” said Hruza. “If you have skin cancer, you don’t have 2 to 3 months to have it taken care of.”

Craft hopes UnitedHealthcare will reconsider its decision.

“If there’s enough groundswell in our community along with others across the nation maybe UnitedHealthcare will back down on this.”

Here is a statement from UnitedHealthcare:

“We believe these changes will improve the health care experience for UnitedHealthcare’s Medicare Advantage members in the St. Louis area. At the same time, we understand that any plan changes can be unsettling. We are working to make the transition to a new doctor as smooth as possible, and will do all that we can to prevent interruptions in care. We urge UnitedHealthcare Medicare Advantage plan members to call our customer service number on their member ID card if they have any concerns or questions.”

UnitedHealthcare also indicated the terminations where the result of market dynamics. The company did not cite the Affordable Care Act as a reason. Reimbursements to private insurers offering Medicare Adantage plans have been reduced to offset the cost of implementing the Affordable Care Act.

Original Article