Read the Connecticut Congressional Delegation's letter to United Healthcare Group CEO
This is the contents of a press release sent out by the office of U.S. Sen. Richard Blumenthal, D-Conn.
It is not edited here
(Hartford,
CT) – In a letter to United Healthcare Group (UHG) CEO Jack Larsen, the
Connecticut Congressional Delegation pressed the company on its
decision to terminate thousands of providers from
its Medicare Advantage Plan. Approximately 32,000 Medicare enrollees in
Connecticut may be impacted by this decision, which came just days
before the Medicare open enrollment period began. The Connecticut
Congressional Delegation’s letter and questions to
UHG are attached and below:
Letter
October 23, 2013
Mr. Jack Larsen
Chief Executive Officer
United
Healthcare Group
9700 Healthcare Lane
Minnetonka, MN 55343
Dear Mr. Larsen,
We
are writing to express our concern regarding the recently announced
changes to the United Healthcare Group (UHG) Medicare Advantage (MA)
plan offered in Connecticut. UHG has long
been an important part of Connecticut’s health insurance market, and we
value your dedication to providing health insurance to the people of
Connecticut and across the country. However, we have heard from our
constituents who are very concerned about the effects
that terminating so many physicians from the UHG MA plan could have for
Medicare beneficiaries in the state. While we appreciate UHG’s
willingness to discuss this issue with members of our staff, we have
some outstanding questions regarding the decisions
that UHG made about provider participation in the UHG MA network.
We
would like to better understand the process of notification by UHG that
was made to your Connecticut participants and physicians in compliance
with CMS requirements for notice.
We also need a better understanding of how network adequacy
requirements will be met despite the sudden drop of what appears to be
nearly one quarter of UHG’s MA provider network. This significant
reduction in physicians raises many concerns about whether
people who have chosen to participate in the UHG program will have
adequate time to make informed decisions about their Medicare coverage
before the open Medicare enrollment period closes on December 7.
We
understand that UHG has similarly streamlined provider networks in
other states, including a reduction of approximately
1,000 providers in the network in New York. Because the UHG MA plans in
Connecticut currently serve around 32,000 members who may potentially
be affected by this decision, we appreciate your efforts to ensure that
these beneficiaries will continue to have
options for using their chosen providers within the MA plans or have
appropriate notice to switch back to traditional Medicare before the end
of the enrollment period.
As you are well-aware, the open enrollment period for MA plans began on October 15, 2013, and will end on December 7, 2013, so we request a response to the attached questions as soon
as possible, but not later than October 31, 2013,
so that we can serve our constituents and address any outstanding
concerns that are brought to our attention in a reasonable amount of
time.
Thank
you in advance for your consideration of our request. If you have
further questions about our request please contact Laurel Sakai in
Senator Blumenthal’s office at 202-224-2823.
Sincerely,
RICHARD BLUMENTHAL
United States Senate
CHRISTOPHER S. MURPHY
United States Senate
ROSA L. DELAURO
Member of Congress
JOHN B. LARSON
Member of Congress
JOE COURTNEY
Member of Congress
JIM HIMES
Member of Congress
ELIZABETH H. ESTY
Member of Congress
Questions
In
order to help us better understand the changes made to the UHG MA
network in Connecticut, we request timely responses to the following
questions:
1.
How many providers will be dropped from the UHG MA plan networks in Connecticut between October 1, 2013, and February 2, 2014, and what are the effective dates of such terminations of their agreements with UHG?
a.
Please provide a breakdown of the number of
providers whose MA agreements were terminated, including where in
Connecticut their practices were located, by county and town. Also
please include the specialty of the practitioners
by their location.
2.
Please provide us with a detailed summary of the number of providers you expect to be in your MA network as of February 1, 2014, sorted by county, town, and specialty.
3.
Please provide the number of days of notice
that beneficiaries will have of these changes to the provider network
prior to end of open Medicare enrollment period.
4.
Please describe the quality
factors that were considered when deciding which doctors would no longer
be a part of the network. While we understand that there is some
proprietary information potentially
involved in some of these decisions, we hope that you will see how this
information is incredibly important for understanding how the people of
Connecticut will be affected. We are willing to work with you to
provide this information in a manner that is consistent
with your confidentiality and proprietary concerns.
a.
If determinations were made
based on quantitative information from the Medicare Star quality
program, please describe how such information was used.
b.
If determinations were made
based on use of specific codes or procedures, please describe which code
or procedure usage was used and how.
5.
We understand that certain exemptions will
be made for beneficiaries, in terms of their care still being considered
“in-network.” One example given was those currently undergoing cancer
treatments with providers who are slated
to be dropped from the UHG MA plan network. Please list the exemptions
and when those providers would officially be considered out-of-network
for those beneficiaries.
|
|
###
|