A federal judge on Friday slapped UnitedHealthcare with an injunction only hours before the insurer was set to drop thousands of physicians and patients from its Medicare Advantage network in Connecticut, Medical Economics reported.
Two Connecticut medical groups won a temporary injunctive order preventing UnitedHealthcare from removing about 20 percent of its provider panel.
"Based on the information in the record, I find that the Associations have met their burden of demonstrating that they will suffer harm that is imminent and cannot be adequately compensated through damages," United States District Judge Stefan R. Underhill said in the ruling.
He also noted the medical associations showed UnitedHealth may have breached physician contracts by improperly terminating certain physicians.
The ruling only affects the Hartford County Medical and Fairfield County Medical associations, although those counties include a majority of the more than 2,200 affected physicians, Medical Economics noted.
The decision against UnitedHealth, which is reducing its provider networks in at least nine other states, could have national implications as medical groups in Ohio and New York may file similar suits, according to Kaiser Health News.
The ruling also forces UnitedHealth to start the termination proceedings from the beginning and "do it the right way," Roy Breitenbach, J.D., legal counsel for the medical associations, told Medical Economics.
Doctors pushing back against the network cuts claimed they could affect roughly 58,000 Medicare Advantage members statewide and disrupt long-term relationships with their physicians, hurting care consistency and outcomes, FierceHealthPayer previously reported.
UnitedHealth said it plans to appeal the decision, but will comply with the ruling as the appeal takes place, KHN noted.
The America's Health Insurance Plans urged the Centers for Medicare & Medicaid Services to allow insurers like UnitedHealth to adjust their Medicare Advantage provider networks to offset federal funding cuts. AHIP warned that restricting network cuts would reduce benefits and increase out-of-pocket costs.
To learn more:
- here's the ruling (.pdf)
- read the KHN article
- here's the Medical Economics article