Medicare Advantage (MA) plans are increasingly dropping doctors and other health care providers from their contracted networks, often in the middle of a plan year, when most plan enrollees are not permitted to change plans. MA enrollees often get little advance warning, and some lose access to doctors they have seen for a long time, despite joining the plan specifically because their doctor was part of the network.
In an effort to strengthen MA enrollee consumer protections, in June 2014, Congresswoman Rosa DeLauro (D-CT) and Senator Sherrod Brown (D-OH) introduced the Medicare Advantage Participant Bill of Rights Act of 2014 (H.R. 4998/S. 2552). Senator Richard Blumenthal (D-CT) is a strong advocate and co-sponsor of the bill. Among other things, this bill would prohibit MA plans from dropping providers during the middle of the plan year unless they can show cause, and would improve notice to plan enrollees about annual changes to provider networks before they commit to joining the plan. The Center for Medicare Advocacy supports this bill.