Kaiser Health News: Draft Rules Would Help Protect Seniors When Medicare Advantage Plans Drop Doctors

This KHN story was produced in collaboration with wapo

Federal officials are considering new Medicare Advantage rules to help protect seniors when insurers make significant reductions to their networks of doctors and other health care providers.

The proposals follow UnitedHealthcare’s decision to drop thousands of doctors from its Medicare Advantage plans in at least 10 states last fall.

The government’s response is part of the 148-page announcement of proposed rules and payment rates for next year’s Medicare Advantage plans released last month by the U.S. Centers for Medicare & Medicaid Services. Officials say that the terminations only a few weeks before Medicare’s Dec. 7 enrollment deadline may not have given seniors enough time to find new doctors, choose a different plan or rejoin traditional Medicare, which does not restrict beneficiaries to a limited network of providers.

The proposals would give beneficiaries more than 30 days’ advance notice of network changes and providers at least 60 days’ advance notice of a contract termination. Even Medicare officials need more advance notice – “no less than 90 days” – so they can ensure that the remaining providers “will continue to meet required network standards.” Officials are soliciting suggestions on how plans should prove that their reconfigured networks are adequate.

The physician terminations sparked protests to Medicare and UnitedHealthcare from patients, as well as physician groups across the country, state officials and members of Congress.

Continue reading here: http://www.kaiserhealthnews.org/Stories/2014/March/24/proposed-medicare-advantage-rules-on-dropping-doctors.aspx

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
  • St. Barnabas Senior Services

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