A U.S. Senate Special Committee on Aging hearing in Hartford focused on Medicare Advantage plans, but it wasn’t long before the conversation turned to one insurance company’s decision to eliminate doctors from its network.
UnitedHealthcare’s decision to drop physicians from its Medicare Advantage network last October became the center of attention Wednesday during the U.S. Senate field hearing at the Legislative Office Building.
U.S. Sen. Richard Blumenthal said what UnitedHealthcare is doing by dropping an estimated 2,200 doctors from its network, is “playing Russian roulette with the health of its patients.”
At a press conference prior to the hearing, Dr. Robert Russo, president-elect of the Connecticut State Medical Society, said there’s a bond between a patient and a doctor, but there’s no bond between a patient and their insurance company.
“Our patient-doctor bond is sacred,” Russo said. “These insurance companies understand that. They understand that those patients won’t leave their doctor so when they dump the doctor they know that patient is going to walk out of their insurance company to somewhere else.”
He said he’s from Bridgeport where there’s an indigent population. “To think that a patient on the south side of Bridgeport that needs dialysis now has to go to Norwalk to get it . . . These people don’t own cars. There’s no way to solve this problem,” Russo said.
Norwalk resident Robert Buccieri, who has stage 5 kidney disease and is on a transplant list, said he knows firsthand the difficulties of trying to make sure his doctors are still in UnitedHealthcare’s network. He said five of his doctors received cancellation notices and he’s been working to make sure he can still continue seeing his doctors.
But it’s complicated. He continues to call UnitedHealthcare, but every time he calls he gets a different answer.
“Some say it’s for a limited time. Some say it’s approved,” Buccieri said.
He said they say the transplant is covered, but if he got something like a staph infection during the surgery or in recovery, that would not be covered.
“It’s hard enough dealing with the situation I have. Now I have to deal with this UnitedHealthcare situation,” Buccieri said.
Technically, none of the doctors will be removed until Feb. 1, but there’s no opportunity after that date to cancel a Medicare Advantage plan.
U.S. Sen. Chris Murphy said there was nothing fair or transparent about what United Healthcare did when it decided to “carve up its network.”
He said that they’re not asking insurance companies that offer Medicare Advantage plans to freeze their networks forever.
“We’re asking them to make sure that when they make changes they notify doctors and allow them the ability to protest, and notify patients and give them the ability to switch plans,” Murphy said. “That’s not what’s happening.”
He said there are “good reasons to control your network, but there are also bad reasons to control your network.”
He said he’s working with Sen. Sheldon Whitehouse of Rhode Island on the issue. Whitehouse, who was at Wednesday’s hearing, said UnitedHealthcare cut about one-third of its provider network in Rhode Island.
“When you have a company that’s being as abrupt and opaque as United, it is very hard to tell if it’s a good reason or a bad reason,” Whitehouse said.
A two-judge panel of the Second Circuit Court of Appeals heard arguments Tuesday regarding the temporary restraining order that prevents UnitedHealthcare from kicking doctors — who belong to the Hartford and Fairfield County Medical Associations — out of its network while the complaint is pending its appeal.
In December, U.S. District Court Judge Stefan Underhill, ruled in favor of the medical associations when he granted the injunction against UnitedHealthcare.
Jessica Pappas, a spokeswoman for UnitedHealthcare, said Wednesday that the changes the company made to the network were in the interest of its members.
“The changes that we and other Medicare Advantage plans are making will bring better health outcomes and more affordable health care coverage to Medicare Advantage members,” Pappas said in a statement. “We are working with local members and doctors to address questions and concerns they may have about these changes.”
Stephanie Kanwit, former special counsel for the trade association America’s Health Insurance Plans, said that customers have 12 Medicare plans to choose from if they don’t like what UnitedHealthcare has to offer.
“I do think there are consumer choices out there,” Kanwit, who was not specifically speaking on behalf of UnitedHealthcare, said.
