UnitedHealth could face HHS scrutiny for network cuts

Frustrated with the lack of information coming from UnitedHealth, which is cutting about 19 percent of doctors from its Medicare Advantage network in Connecticut, Attorney General George Jepsen is asking the U.S. Department of Health & Human Services to get involved.

Jepsen said UnitedHealth has declined to provide his office with information about the cuts, including the number of doctors and members affected, the Hartford Business Journal reported.

"We are deeply troubled by United insisting that its remaining provider network will be adequate despite simultaneously claiming not to know the number of patients affected," Jepsen wrote Wednesday in a letter to HHS.

The Connecticut State Medical Society estimated UnitedHealth's cuts could affect roughly 58,000 Medicare Advantage members, disrupting their long-term relationships with physicians and potentially leading to inconsistent care and poor health outcomes.

But Jepsen said UnitedHealth still hasn't notified members whose doctors have been cut from the Medicare Advantage plan even though open enrollment closes Dec. 7, reported the Associated Press.

The Connecticut attorney general office doesn't have authority to compel UnitedHealth to disclose the requested information or extend Medicare Advantage enrollment periods.

"As you know, my office lacks the authority to resolve these important issues regarding a federally administered program," Jepsen wrote to HHS. "Consequently, I urge your agency to aggressively scrutinize this large and potentially harmful provider termination initiative."

But UnitedHealth disagrees with Jepsen's characterization of its correspondence with the attorney general's office. "We have worked with and will continue to work with the Centers for Medicare & Medicaid Services and others, including the Connecticut Attorney General's office, to help address the needs of local providers and members and further explain the changes we are making to our Medicare Advantage network," Maria Gordon Shydlo, UnitedHealth's public relations director, told CT News Junkie.

To learn more:
- here's the attorney general letter (.pdf)
- read the Hartford Business Journal article
- see the Associated Press article
- check out the CT News Junkie article

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