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CT Physicians, UnitedHealth Head to Mediation

Jacqueline Fellows, for HealthLeaders Media, January 23, 2014

"The changes that we and other Medicare Advantage plans are making will bring better health outcomes and more affordable health care coverage to Medicare Advantage members," says Pappas.

"While these changes can be difficult for patients and their doctors, they are necessary to meet rising quality standards, slow the increase in health costs and sustain our plans in an era of Medicare Advantage funding cuts. Our focus remains on supporting our members and helping them access the care they need."

The providers are upset because they claim UnitedHealth's action limits patients' access to care. Beneficiaries are confused over why their longtime doctors are no longer part of their plan.

The issue has drawn in the American Medical Association and America's Health Insurance Plans. The AMA signed a brief in support of Connecticut's move to avert provider reductions, and AHIP sent a letter to the Centers for Medicare & Medicaid Services in November asking the federal agency to resist preventing insurers from cutting some providers loose.

"We are concerned that efforts are underway to encourage CMS to limit efforts by MA plans to establish more focused, high-performance networks …." wrote Karen Ignani, President and CEO of AHIP.

The physicians in Connecticut bolstered their case on Wednesday, the day after the federal appeals court listened to arguments, at a Senate Special Committee on Aging field hearing, which also took place in Connecticut, on the very issue of how Medicare Advantage changes affect consumers.

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