Last month, two Connecticut medical associations filed suit against UnitedHealthcare challenging the insurer’s termination of the physicians as participating providers in United’s Medicare Advantage Networks. The suit alleged United’s actions violate Medicare regulations as well as United’s agreements with providers.
U.S. District Court Judge Stefan Underhill took issue with United’s proposed strategy of eliminating the physicians by unilaterally amending their contracts. “United’s argument that it has a unilateral right to terminate participating physicians from participation in the Medicare Advantage plan by ‘amendment’ of that plan is not supported by the language of the contract or the parties’ experience under it,” he wrote in his decision.
The Fairfield County Medical Association and The Hartford County Medical Association, the organizations that had filed the suit, applauded the ruling. “We won’t let UnitedHealthcare get away with interfering with the doctor-patient relationship,” said Robin Oshman, MD, president of the Fairfield County Medical Association.
The decision could have national implications, according to a Kaiser Health News report. Representatives from other states’ medical associations are reviewing the decision and several are considering similar legal action. “This is very good news from Connecticut,” said Sam L. Unterricht, MD, president of the Medical Society of the State of New York, in the report. “We will definitely seriously consider filing a suit in New York as well.”
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