nothin DeLauro, Blumenthal Seek Medicare Fix | New Haven Independent

DeLauro, Blumenthal Seek Medicare Fix

Thomas MacMillan Photo

After a Medicare Advantage plan abruptly dropped him and hundreds of other physicians, Dr. Steven Wolfson tearfully said goodbye to patients of 30 years and offered some final advice: Don’t get sick.

Wolfson (pictured), a cardiologist at the Yale School of Medicine, shared his experience Monday morning at a roundtable” discussion of a new bill designed to protect Medicare Advantage beneficiaries from bait and switch” maneuvers by health care plans.

That’s how U.S. Sen. Dick Blumenthal described a recent move by United Healthcare Group, which had dropped hundreds of doctors from its Medicare Advantage plans. That move forced senior citizens to lose physicians they may have had for decades and find new doctors who may be a significant distance from their homes.

Blumenthal was joined for Monday’s event, at Atwater Senior Center in Fair Haven, by U.S. Rep. Rosa DeLauro, New Haven Mayor Toni Harp, and representatives from medical associations.

Blumenthal and DeLauro are proposing bills that would prevent Medicare Advantage plans from dropping doctors without cause except during open enrollment periods. Plans would have to finalize their provider networks 60 days before the annual open enrollment period begins.

This bill arises from a hugely wrong and exploitative practice by United Healthcare,” Blumenthal said. He said the company dropped 2,250 doctors across the state, affected some 32,000 patients. Doctors sued and won an injunction.

Wolfson said United Healthcare dropped all Yale medical school doctors, as well as all doctors with admitting privileges at Yale-New Haven Hospital, and the hospital itself.

The bait and switch” happened after people signed up for plans, then found they couldn’t access the doctors they had been promised, Blumenthal said.

It affected most particularly our elderly and frail,” he said. It was morally wrong. We need to make it legally wrong.”

If you buy a car, you don’t expect to have a bicycle delivered,” said Judy Stein, head of the Center for Medicare Advocacy.

United Healthcare’s market share in Connecticut dropped from 45 to 36 percent, said Mark Thompson, head of the Fairfiled County Medical Association. Because United Healthcare gets a flat-rate reimbursement from the federal government, it was able to increase its profits even as it lost doctors. It got rid of the specialists with the patients who require the most expensive care.

Normally, losing customers is a bad thing,” Blumenthal said. But United Healthcare wanted to lose customers — to increase revenue.

This is their business model,” said U.S. Rep. DeLauro (pictured).

We continue to offer Medicare Advantage enrollees a broad choice of primary care physicians and specialists in Connecticut and elsewhere, and are committed to ensuring Medicare beneficiaries have access to quality, affordable care,” said United Healthcare spokeswoman Maria Gordon Shydlo.

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