The agency that oversees Medicare is reviewing United Healthcare’s Medicare Advantage network in Connecticut to ensure it meets federal standards, but it hasn’t found any rule breaking in the way the insurer severed ties with an estimated 2,200 doctors in October, an official said in a letter to state Attorney General George Jepsen.
Jepsen asked the Center for Medicare and Medicaid Services earlier this month to “aggressively scrutinize” the adequacy of the provider’s remaining network in the state, and to determine how many patients have been affected and if they and their doctors were given adequate notice.
He said the cuts are unprecedented in scope and have lacked transparency for doctors and patients.
Douglas J. Edwards, associate regional administrator at CMS, told Jepsen in the Nov. 21 letter, which Jepsen released today, that the review of UHC’s network is ongoing.
If deficiencies are found, the insurer will be required to let patients see out-of-network providers until the problems are fixed.
But Edwards said the insurer appears to have given doctors and patients more than the required amount of notice — 60 days and 30 days, respectively, before the effective date of Feb. 1, 2014.
But doctors and others have argued that the notices have crunched patients trying to sign up for Medicare plans in the open enrollment period that ends Dec. 7.
Edwards wrote that extending the enrollment period to give beneficiaries more time — which Jepsen had requested — is not warranted.
He also pointed out that insurers are allowed to change the composition of their networks in any new contract year.
In a letter Jepsen sent in response today, he urged CMS to reconsider its enrollment extension decision.
He said he’s “deeply skeptical” that CMS has enough time any network inadequacies before Dec. 7.
United has continued to refuse to disclose the number of Connecticut beneficiaries whose doctors received dismissal notices, Jepsen said.
Read more
United Health: Obamacare will cost us $1.9B in 2014
