November 22, 2013

While the federal Centers for Medicare & Medicaid Services (CMS) will review United Healthcare’s provider networks following the insurance company’s decision to eliminate a significant number of doctors from its Medicare Advantage Plan networks beginning next year, Attorney General George Jepsen said today that the federal regulators need to do more to support vulnerable patients affected by the terminations.

“I appreciate CMS’s response to my request, and I hope the promised review will be as thorough as possible,” said Attorney General Jepsen. “However, I am not satisfied with CMS’s response, and I am gravely concerned that the burden these terminations place on seniors has been greatly underestimated.”

In a letter sent earlier this month, Attorney General Jepsen asked federal regulators to “aggressively scrutinize” United’s network to ensure its adequacy and to extend the open enrollment period for affected patients to allow for a reasonable opportunity to make decisions about their care.

“CMS stated that it does not intend to extend the open enrollment period at this time,” the Attorney General said. “The scope of United’s reductions is unprecedented, and the process has lacked transparency for both physicians and patients. According to CMS, notices were issued to patients on November 15 and 16, and the open enrollment ends December 7. Without an extension of time, and while providers are still appealing their terminations, it is unreasonable to expect patients to be able to make informed decisions about their choice of health plan. CMS’s suggestion that patients can simply dis-enroll at a later time is not sufficient.”

The Attorney General continued, “I have written back to CMS to express my objections and concerns. I encourage all affected Connecticut residents, their families and caregivers and any other resident with concerns about this matter to express those concerns directly to CMS in order to help that agency better understand the widespread impact that United’s termination plan will have on patient care.”

The Attorney General said that he has directed his staff to monitor, to the fullest extent of his authority and ability, if affected patients are safely transitioning to new and appropriate in-network physicians and that his office stands ready to assist CMS in identifying any network deficiencies.

Assistant Attorneys General Thomas Ryan and Charles Hulin, with Special Counsel Robert Clark, are assisting the Attorney General with this matter.

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