Connecticut Congressional Delegation Concerned about Medicare Advantage Network Provider Terminations in the StatePosted in Article
As noted in a press release issued by Rep. Rosa DeLauro’s office, on September 30, 2019, members of Connecticut’s congressional delegation sent a letter to the President of Anthem Blue Cross Blue Shield to “express our concern regarding the recently announced provider terminations from Anthem Blue Cross and Blue Shield’s (Anthem) Medicare Advantage (MA) network in Connecticut.”
Although the number of physicians being terminated is not clear, an early estimate by the Connecticut State Medical Society indicated that Anthem is terminating almost 2,000 physicians in the state from at least one of their MA plans, effective January 1, 2020.
The congressional letter notes that “Anthem’s decision to terminate Connecticut physicians from its network will leave an insufficient network that will not provide adequate access to care for many in our state, particularly for certain specialties in medically underserved areas of the state.”
As noted by the Connecticut news website CT News Junkie, this isn’t the first time that a large number of providers have been terminated by an MA plan: “In a similar situation with a different insurer in 2013, a federal judge agreed with two medical associations that United Healthcare should stop dropping doctors from its Medicaid Advantage network. The insurance company appealed the decision and the federal Centers for Medicaid and Medicare Services said the networks were adequate.”
The 2013 MA doctor cuts occurred in numerous states, after people had already made their enrollment choices for the year. As we enter the Medicare enrollment period for 2020, advocates and beneficiaries should remember that these kinds of changes to physicians and health care providers can occur in Medicare Advantage.
October 3, 2019 – D. Lipschutz