Thousands of Ohioans unaware of doctor cuts

Practices are located across the state.
MCT Regional News
Jan 15, 2014

About 5,000 Ohioans were unaware that their doctors had been dropped from their Medicare Advantage plan on Jan. 1, according to their insurer, United Healthcare, which attributed the oversight to a database error.

The company said it would move “as quickly as possible” to notify its members and would continue to honor claims from the approximately 660 affected physicians and their patients for at least the next two months.

“We deeply regret any confusion this error has caused for our members and their physicians,” said Kevin Shermach, a United Healthcare spokesman. “We have taken action to support these members, including extending in-network benefits with affected providers through March 31, 2014.”

The company said it would reassign affected policyholders to a new primary care physicians in its Medicare Advantage network this year.

Shermach said the notification oversight was limited to Ohio, where the health insurer serves about 102,000 individual Medicare members.

United Healthcare’s decision to drop hundreds of physicians from its Medicare Advantage plan came under fire from the Ohio State Medical Association late last year.

The health insurer said it was narrowing its provider network in response to cuts in reimbursements to Medicare Advantage called for under the Patient Protection and Affordable Care Act.

But the medical association complained the cuts were too deep and asked the Centers for Medicare and Medicaid Services to investigate whether United Healthcare’s move to trim its provider network would compromise coverage for seniors in Ohio.

As a result, the medical association said at least 10 practices with more than 75 doctors have been reinstated to United Healthcare’s Medicare Advantage network in Ohio.

The practices are located across the state, from Cincinnati to Cleveland, and range from a solo practitioner to a group with 21 physicians, according to a post on the association’s website.

“While this is a positive first step, much work remains to ensure that United HealthCare Medicare advantage patients have adequate access to care. There are still a number of terminations that the OSMA remains concerned will lead to network adequacy issues for patients across Ohio,” the post reads.

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By Randy Tucker - Dayton Daily News, Ohio (MCT)

©2014 the Dayton Daily News (Dayton, Ohio)

Visit the Dayton Daily News (Dayton, Ohio) at www.daytondailynews.com

Distributed by MCT Information Services

Comments

JACKEL

Just the beginning folks,I hope you are happy with your King.One of the local doctors just informed a friend he can no longer treat their family.I am told Willard has a shortage already !

Whiskey Tango F...

No pay... No service. Sorry, gonna side with the docs on this one. I won't work for less than half of my bill, why should they? The headline should read..."United Healthcare cuts reimbursement to the point that docs will no longer work for what they pay"

jas

Doctors have been getting out of the profession for more than 10 years because their malpractice insurance rates have gone up. This has occurred even though the number of lawsuits filed and the money paid out has remained stable. Their rates have gone up because the insurance companies have lost a lot money playing the stock market. It has absolutely nothing to do with more lawsuits which hasn't happened or the Affordable Care Act. It's good old fashion greed by the insurance companies. They're using the Affordable Care Act as an excuse for something they've been doing for years

Contango

Re: "Their rates have gone up because the insurance companies have lost a lot money playing the stock market."

BS.

Ins. cos. are notoriously conservative with their investments; mostly real estate and collateralized loans.

The fact is that the Dems are anti-tort reform because they enjoy the legal lobby's campaign money.

deertracker

Are you REALLY saying ins. cos. are not greedy!?

Contango

Re: "ins. cos."

A lousy business with low profit margins.

Do you REALLY believe that lawyers are not greedy? :)

Do you REALLY believe that Democrats don't like the legal lobby's campaign cash?

KnuckleDragger

Apparently he does Contango, since jas is a lawyer.

deertracker

@jas
Agreed!

swiss cheese kat's picture
swiss cheese kat

Jas is full of bs.

Malpractice Premiums Drop for 6th Straight Year

http://www.medscape.com/viewarti...

KnuckleDragger

So, we are to take the word of a lawyer?

In my opinon

@ jas..Agree with you whole heartedly, talked to a retired Doc recently and told him wished he was still practicing and he said he would not have retired but the cost of malpractice ins. was the deal breaker, other Doc's have left and gone back to their prospective countries because of the ins. costs. Some posters on here will blame present administration for any and everything.

KURTje

Agree with jas. Talked to a 90 something retired doctor. Asked him what was the biggest change he'd witnessed in his years of practice. He thought for a moment then stated, "D*mn lawyers." That conversation was years ago.

jas

Every time so called "tort" reform comes up, the doctors and insurance companies whine about all the medical malpractice cases filed. The Wall Street Journal has done several articles that show the number of medical malpractice lawsuits filed as well as the amount of money paid out in law suits has risen less than the rate of inflation over the last 30 years.

The costs of malpractice premiums consistently tracks the return on investments that the insurance companies make. When insurance companies are making money on their investments, malpractice premiums do not increase vey much whereas the premiums increase greatly when their investments do poorly. Lawsuits are totally irrelevant to how much malpractice premiums go up.

I think it's fair to believe that since the insurance companies want us to believe the big lie that more lawsuits cause malpractice premiums to go up, it's also likely a big lie that the Affordable Care Act will do the same. The bottom line as always will be that the insurance companies will arbitrarily raise their rates and blame something else besides their own enormous greed for doing it.

Contango

Re: "the number of medical malpractice lawsuits filed as well as the amount of money paid out in law suits has risen less than the rate of inflation over the last 30 years."

Sources? Just stating WSJ doesn't cover it. Opinion pieces also include progressives and others.

Regardless; a specious argument.

How 'exactly' does the "rate of inflation" correlate to number of lawsuits?

Also, from the WSJ, reflecting my other point:

"But this is the one reform (tort) Washington will not seriously consider. That's because the trial lawyers, among the largest contributors to the Democratic Party, thrive on the unreliable justice system we have now."

http://online.wsj.com/news/artic...

FTFOI

Affordable Care Act did not help. We will be seeing a lot more repercussions from Obama care

Contango

Re: "narrowing its provider network in response to cuts in reimbursements to Medicare Advantage called for under the Patient Protection and Affordable Care Act."

Trimming the reimbursement percentage amounts in Medicare AND Medicaid will cause many docs to leave the medical field or to practice concierge (private pay) service.

Just wait until the progressive-socialists eventually get their "single payer" and it's all FREE.

KnuckleDragger

"If you like your doctor, you can keep them."
-President Obama

LMFAO!!!

Cliff Cannon

I am confused, misguided, upset and unable to afford to be in a hospital. Oh that's right, my bad, I am supposed to be. We're discussing federal health insurance here and I am not on welfare.

Dr. Information

Meanwhile, office overhead has nearly doubled over the last 10 years. Why anyone would want to be a government doctor these days is beyond me. Move to a city where you get people who have private insurance if you want to make money and not be in debt the rest of your life.