This is a small number but it’s better than nothing as it looks like the association did their homework with some obvious extreme cases as mentioned below with cutting two
gastroenterology practices, the only ones in the region from their network. Since that was the case it appears perhaps the United decisions and algorithmic formulas used to make the cuts of doctors seeing Medicare Advantage patients came up short in the “big data” department as that’s part of the big complaint here, to not rule out all potential specialists and family practice doctors in regions, so patients don’t end up with big road trips to see a doctor when needed.
If you have been following this then you know there are more states than just Ohio affected here with Connecticut and New York included in the mass firings. As I said in a prior post “algorithm says”…
United Healthcare Medicare Advantage Doctor Firing Moves On Into Ohio, New York, And Maybe More? CMS Has Known For Months About the Changes And Is Monitoring….United’s Cost Algorithm Says…You’re Out the Door
Meanwhile back at the ranch, United has invested around $9 million in low income property rentals in Ohio with HUD kicking in a little bit too, and in addition they invested another $50 million in a housing project in Minnesota.
UnitedHealthcare Doesn’t Want To Let Wall Street Own All the Rentals, One More Housing Community Opened in Ohio With An Almost a $9 Million Dollar Investment, While Doctors Caring for Medicare Advantage Patients Are Being Cut From Their Networks…
The news article said below there could be more changes coming and the 10 practices represent about 75 doctors who are getting reinstated. Here’s what’s happening in New York with a new lawsuit filed there regarding the same issue. BD
Medical Society of the State of New York Files Lawsuit Asking Court to Intervene To Prevent United Healthcare From Dropping Around 2000 Doctors From Medicare Plans
About 10 practices representing roughly 75 Ohio doctors have been reinstated to UnitedHealthcare’s Medicare Advantage network in Ohio, in the wake of appeals by a physician-advocacy group.
But potentially hundreds of other doctors in the state, including a large ophthalmology practice that serves central and southern Ohio, have not had their terminations overturned, said Reginald Fields, spokesman for the Ohio State Medical Association.
Most of UnitedHealthcare’s reinstatements cover doctors in southwestern Ohio, including a 22-doctor gastroenterology practice in Dayton, where the only two large gastroenterology practices had both received termination notices. The other practice’s Medicare Advantage status with UnitedHealthcare remains under review, Fields said.
The association has been challenging UnitedHealthcare’s paring of hundreds of physicians from its Medicare Advantage network, saying such cuts would leave the large health insurer with an inadequate provider network for enrollees.
UnitedHealthcare has about 102,000 Ohioans enrolled in six Medicare Advantage plans. About 36 percent of Ohio’s 2 million Medicare enrollees are in Advantage plans.
http://www.dispatch.com/content/stories/local/2013/12/28/medicare-network-reinstates-doctors.html
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