Insurer Reaches Agreement with Provider Network – After Frightening Medicare Advantage Enrollees
Last month in Connecticut, United Healthcare (UHC) set off a panic among its Medicare Advantage (MA) enrollees by sending out letters indicating that they would no longer be affiliated with Hartford HealthCare HHC), one of Connecticut’s largest provider networks.
These MA enrollees often received multiple letters – one for each of their HHC providers. One older person with multiple conditions called the Center for Medicare Advocacy greatly alarmed, having received 14 letters telling her that care from her providers would no longer be covered. The letters indicated that patients would need to find new primary care physicians, specialists, home health agencies, and hospitals. Some patients who contacted the Center had surgeries scheduled that week.
The Center contacted UHC and was told that negotiations were actually ongoing, and the letter that was sent should have indicated that. We were told that a corrected letter would be sent, but that the process could take a long time.
In mid-April, negotiations between UHC and HHC finally concluded successfully. HHC patients and providers will now be sent letters from UHC indicating that a new 2-year agreement has been reached. The patient letters emphasize that there will be no disruption in coverage, and that those patients who received the earlier letters can continue to see their HHC providers. Some patients, however, likely already experienced disruptions, as they scrambled to find new providers based on the earlier letter.
The Center is very concerned with how United Healthcare handled this matter, and urges CMS to ensure it doesn’t happen again. Nonetheless, insurers are obligated to give notice if enrollees are going to lose access to their caregivers. Medicare Advantage enrollees in every state should take heed – be very aware of network limitations and obligations, and be prepared for the possibility of sudden change.