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Medical Groups Sue United Healthcare

HARTFORD — The Hartford County Medical Association joined the Fairfield County Medical Association to file a federal court lawsuit challenging UnitedHealthcare’s termination of more than 2,000 physicians who participate in United’s Medicare Advantage Networks.

These terminations are due to take effect Feb. 2014.

According to the lawsuit, UHC’s actions violate the Medicare regulations, and are in breach of UHC’s agreements with its physician members.  The suit explains that UHC’s actions have “a significant adverse impact not only on the terminated physicians, but on their longstanding elderly and disabled patients, who must now either find new physicians (including traveling farther distances to find a participating MA provider), switch plans to continue treatment with the terminated physician, or incur significant additional out-of-pocket costs to continue treatment with an ‘out-of-network’ provider.”

The lawsuit further notes that “patients may be forced to change and to reluctantly go elsewhere for medical care, which is particularly difficult for the elderly and/or disabled.

There will likely also be patients so discouraged by United’s changes that they may even be unwilling to seek covered preventative care.  This will shift the geriatric population to a crisis-oriented culture which further impacts the health and safety of Medicare beneficiaries and increases the cost of their healthcare, a situation that the Affordable Care Act was meant to address.”

“UnitedHealthcare’s plan will mean the termination of more than 2,200 physicians statewide, that’s almost 20 percent of its entire network and that it turn would have an adverse impact on the delivery of medical care to patients,” according to Dr. Robin Oshman, President of the Fairfield County Medical Association.

Dr. Bollepalli Subbarao, President of HCMA., concurred and added that ” we cannot sit back and let this happen, to our doctors, or to our patients, especially when UnitedHealthcare said that this has nothing to do with the quality of physicians terminated, and in our opinion is all about profits.”

Both said that representatives from both FCMA and HCMA note that UHC’s terminations are misleading many Medicare beneficiaries are not being informed that their medical provider is no longer available, they said.

The lawsuit also alleges that United is “shifting the financial burdens imposed by the Affordable Care Act from itself, a multi-billion dollar company, to the providers and patients, all with the aim of maximizing revenues.”

This, they said, is an attempt to undermine clear legislative policies and is being done solely for the sake of profits.

Both groups are seeking a court declaration that United’s attempted terminations are illegal. They also want an injunction preventing UHC from terminating any of the Associations’ physician members.

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