United Healthcare Medicare Advantage Doctor Firing Moves On Into Ohio, New York, And Maybe More? CMS Has Known For Months About
Posted Nov 05 2013 2:01am
Here’s one more state, the same deal and nobody will answer the doctors calls and explain why so more seniors having to switch plans or doctors. So far Connecticut and Florida have been hit and some doctors just as recently as August renewed contracts with the company. The worst thing here I am reading in all of these articles is that United refuses to talk to the doctors or give them a reason why…they are just letting their math models and subsequent algorithms kick out letter…no human side to this at all.
According to the article below CMS has known for months about the changes? Lately with the website and work I have seen coming out of CMS and HHS, you can’t put a lot of faith in their procedures but United could have just fired off an email there too…and thus we get “they have known for months” maybe? In addition the article says they have met all the notification requirements? What are we running here…more Attacks of the Killer Algorithms? I said recently that Obamacare is all about the math and business profit analytics…and here’s more of it..
So is this the future, set the email algorithm up to do the work and avoid the phones to answer questions, at least the doctor’s questions here. It further says CMS is monitoring the situation for compliance…I don’t put any stock at all in that. I said way back in 2009 that Sebelius was no match for the complex profit models and math insurers use, and he we go again, she loses as well as CMS. United doesn’t need the policies obviously and if you have never looked, see the huge list of 15 pages of SEC subsidiary companies they own and what kind of businesses they are in, breath taking. BD
One of the largest Medicare managed-care insurers in Ohio has been dropping doctors from plans that cover thousands of area seniors.
Marc Braun, 66, of Bath Township, is among those being forced to find a new doctor or switch insurers after recently being told UnitedHealthcare will no longer include his physician in its Medicare Advantage plans.
About 102,000 Ohio residents are enrolled in UnitedHealthcare’s Medicare managed-care plans.
The plans are optional for people covered by Medicare, the federal health insurance program for people ages 65 and older and some younger disabled Americans.
About 5,600 of the nearly 46,000 Summit County residents enrolled in Medicare Advantage plans are covered by UnitedHealthcare, some of which are marketed under the AARP name, according to the Centers for Medicare and Medicaid Services.
Other UnitedHealthcare plans aren’t impacted by the changes.
Several prominent dermatologists, neurosurgeons and other specialists that already are in high demand are among the area doctors dropped from the insurer’s Medicare Advantage local provider network, said Dr. Waleed W.F. Nemer, president of the Summit County Medical Society
UnitedHealthcare has shared information for several months with CMS about its plans to change its provider network, according to a CMS spokesperson. The insurer met all requirements for notifying doctors and enrollees about the changes.