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The ISMA seeks answers from UnitedHealthcare
e-Reports, Nov. 12, 2013
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The ISMA is still fielding calls from Indiana medical practices that have received letters from UnitedHealthcare, advising physicians they have been unilaterally terminated from the carrier’s Medicare Advantage network. The ISMA continues to advise physicians to appeal; refer to www.ismanet.org for a list of factors considered in appeals.

“Note that each letter indicates a deadline for appeal,” said Julie Reed, ISMA general counsel. ”Pay close attention to that deadline.”

The ISMA has repeatedly contacted UnitedHealthcare, and company officials have agreed to discuss the matter with the ISMA at a date not yet determined.

The ISMA staff also is communicating with the Indiana Department of Insurance (IDOI) and learned the insurance commissioner is quite concerned about this situation, particularly since it is occurring during open enrollment. The IDOI is waiting for details requested from United before possibly issuing a consumer alert.

The ISMA spoke to Centers for Medicare & Medicaid Services officials who assured us United will provide information. The ISMA has also been in contact with other state medical societies, and efforts are being coordinated on a national level. A letter about the situation, is being drafted for Marilyn B. Tavenner, CMS administrator; see the proposed draft, which the ISMA has agreed to sign, here.

Regularly check the ISMA website for updates in the weeks ahead.

Copyright: Information written and displayed on www.ismanet.org is the property of ISMA and may not be reproduced without expressed written permission of the Indiana State Medical Association.

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