Doctors Dropped From Medicare Ask State Leaders For Help

Oct 23, 2013

United Healthcare has notified an unknown number of Rhode Island doctors that they’re being cut from its Medicare Advantage plan network. The news comes during Medicare’s open enrollment period and could affect thousands of senior citizens in the Ocean State.

Credit Wikimedia Commons

United’s decision to drop some doctors means that some of the estimated 36,000 seniors in its Medicare Advantage plan in Rhode Island could have to pay out-of-network prices to continue seeing those doctors or find a new provider. And it means that the affected Rhode Island doctors could lose some business.  United Healthcare has not said why it’s dropped these particular doctors. But Rhode Island Medical Society spokesman Steven DeToy said some patterns are emerging.

"A, they’re smaller practices. B, they have a lot of Medicare Advantage patients that are probably costing United more money than other patients." DeToy said. "And it seems to be more the sub-specialists than it does family and primary care, but we are hearing that there are primary care docs in there also.”

DeToy said that includes Block Island’s health service – where the number of providers is limited. He’s also heard from nurse practitioners and podiatrists who are being cut from the network. DeToy said the medical society has notified Rhode Island’s Attorney General and Office of Health Insurance Commissioner, as well as the state’s congressional delegation, about doctors’ concerns.