Legislation that would prevent Medicare Advantage plans from dropping providers in the middle of the year has been introduced in Congress.
Sens. Sherrod Brown (D-Ohio), Richard Blumenthal (D-Conn.) and Rep. Rosa DeLauro (D-Conn.) introduced The Medicare Advantage Participant Bill of Rights Act, which would require Medicare Advantage plans to finalize their provider lists 60 days before the annual enrollment period.
The legislation would prevent plans from dropping healthcare providers without cause outside of open enrollment, which would help ensure seniors would not abruptly lose access to their physicians.
"This measure vitally protects elderly and frail patients from losing physicians they know and trust," said Sen. Blumenthal, in a news release. "At a time when seniors are most vulnerable and fragile, the law should prevent insurers from exploiting them and their health providers."
The bill would also require Medicare Advantage plans to disclose the reasons for dropping providers and require CMS to redesign the tool that enables patients to compare plans.
Rep. DeLauro announced her intention to introduce the bill in April. She introduced the legislation in response to UnitedHealthcare's move to cut thousands of providers from its Medicare Advantage networks at the end of 2013. "The timing and scale of UnitedHealth Group's provider cuts have been extremely disruptive to patient care and put participants at risk," said Rep. DeLauro, in a news release. "We have a responsibility to ensure Medicare Advantage plans are serving the needs of their participants."
UnitedHealthcare is the country's largest provider of privately managed Medicare Advantage plans, and the company has made cuts in networks in many states, including Alabama, Connecticut, Florida, Georgia, Massachusetts, North Carolina, Rhode Island, Missouri and Tennessee.
Sen. Blumenthal's decision to introduce the legislation was also partially prompted by UnitedHealthcare. "Our experience with United Healthcare Group — unconscionably dropping hundreds of physicians — provides powerful evidence for this stronger protection."
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