The OSMA Continues Efforts Addressing UHC Medicare Advantage Plan Terminations

UPDATE (1/16/14): United Healthcare Update: 5,000 UHC Patients Never Told Their Doctor Was Terminated from UHC’s Medicare Advantage Program; Error Impacts 660 Physicians

When United Healthcare terminated hundreds of Ohio physicians from their Medicare Advantage program last fall they failed to notify about 5,000 of their patients that they would have to find a new doctor, UHC officials said on Tuesday. In making the startling admission UHC representatives revealed that UHC Medicare Advantage patients impacted by this error were associated with 660 Ohio physicians who learned they would be eliminated from the program in 2014. Read more here.

UPDATE (12/19/13): OSMA Gets Results! United HealthCare Physician Termination Update

The Ohio State Medical Association’s (OSMA) efforts addressing United HealthCare’s recent decision to terminate hundreds of Ohio physicians from its Medicare Advantage plans are beginning to pay off. The OSMA has heard from individual practices and the Centers for Medicare and Medicaid Services (CMS), the federal agency the OSMA asked to investigate whether the UHC’s decisions were warranted, who report that at least 10 practices with more than 75 doctors have been reinstated to UHC’s Medicare Advantage Network in Ohio. Read more here.

Meanwhile, the OSMA’s efforts advocating on behalf of physicians continues to draw state and national media attention. On Wednesday, CNN featured the OSMA’s work in a story that you can view here.

UPDATE (12/2/13): The OSMA continues to be at the forefront of this issue as a resource for news media. Read the latest story, "Patients thrown for a loop as doctors get dropped," published in USA Today.

UPDATE (11/18/13): The OSMA sent letters to Congressional leaders today regarding the UHC physician terminations. Click to read the letter sent to U.S. House of Representatives Speaker John Boehner.

UPDATE (11/13/13): UHC responded to OSMA today, offering updates and clarifications surrounding the Medicare Advantage terminations. To read the memorandum, click here (login required).

The Ohio State Medical Association (OSMA) continues to aggressively press United Healthcare (UHC) for an explanation regarding their recent decision to terminate physicians from their Medicare Advantage plans and leaving parts of the state with potential network adequacy issues.

OSMA physician leaders and staff have met several times with UHC officials who have explained the rationale for their decision to terminate physicians from the Medicare Advantage plans, but they have also acknowledged there may be some unintended consequences across the state.

The OSMA has also contacted the Centers for Medicare & Medicaid Services (CMS) and encouraged the federal agency to investigate whether the terminations have left some patients without adequate health care coverage within close proximity of where they live. At the invitation of CMS, the OSMA has written CMS to formally request that it investigates this matter. The OSMA has attached to the letter 18 specific examples of network adequacy issues relayed to us by OSMA members impacted by UHC’s Medicare Advantage terminations.

The OSMA has also fielded several calls from Ohio’s Congressional Delegation who have asked for more information on how the UHC’s terminations are impacting physicians and patients in areas they represent. The OSMA is preparing to formally respond to the elected leaders by urging them to encourage CMS to follow through on its inquiry and report back on its findings.

The OSMA has continued to respond to the needs of its members by also providing a form letter that members can use to send to their patients that explains to patients why their doctor can no longer provide health care services under UHC’s Medicare Advantage plan. This is important because some OSMA members have reported that their patients are under the mistaken belief that the doctors have voluntarily exited the plans.

All of this has followed extensive coverage in Ohio the week of Oct. 27 in which the OSMA was prominently featured in state and national newspaper stories highlighting the fallout from the UHC terminations letters.

OSMA physician leaders and staff remain in contact with UHC leaders who have also vowed to review the network adequacy issues raised by OSMA members. We will continue to provide updates via the OSMA Community, the OSMA website and in the OSMA This Week e-newsletter.

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