Last fall, UnitedHealthcare (UHC) told thousands of primary care doctors and specialists in the UHC network they would be dropped in early 2014. New legislation submitted by two members of Congress, called the Medicare Advantage Participant Bill of Rights Act, would require Medicare Advantage plans to finalize their physician networks 60 days before the Medicare Annual Election Period begins.
U.S. Rep. Rosa DeLauro, D-Conn, 3rd District, introduced the legislation in the U.S. House. A companion bill was introduced in the Senate by U.S. Sen. Sherrod Brown, D-Ohio, and U.S. Rep. Richard Blumenthal, D-Conn.
The purpose of the new bill is to keep patients from loosing access to their in-network doctor and specialists mid year. The action by UHC last year forced thousands of seniors to pay higher out-of-network rates, switch physicians, or scramble to find a new plan.
The new bill requires Medicare Advantage plans to disclose the reasons for terminating contracts with healthcare providers. If passed, the new bill will also force the Centers for Medicare and Medicaid Services to redesign its online search and compare tool at Medicare.gov.
Blumenthal expressed how UHC’s action brought consequences for “our most elderly and frail seniors.”
“The point is to provide certain standards that are specific and enforceable so as to leave no doubt that there is protection against this very arbitrary and self interested step by insurers,” Blumenthal said Thursday when the bill was announced.
In her public statement, DeLauro said, “The timing and scale of UnitedHealth Group’s provider cuts have been extremely disruptive to their Connecticut patients and put them at risk. We have a responsibility to ensure that Medicare Advantage plans are serving the needs of their participants.”
Jessica Pappas, UHC spokeswoman, followed by saying, “We continue to offer Medicare Advantage enrollees a broad choice of primary care physicians and specialists in Connecticut and elsewhere, and are committed to ensuring Medicare beneficiaries have access to quality, affordable care.”