Medicare

A federal judge in Connecticut is blocking United Healthcare’s move to drop hundreds of doctors from its Medicare Advantage network.

The Hartford Courant reports that the Fairfield and Hartford County Medical Associations convinced the court that removing the more than 2-thousand doctors in Connecticut from the health insurance network would be too damaging. And that the insurer plans to appeal the decision.

RIPR health care reporter Kristin Gourlay joined host Dave Fallon in the studio to talk about what United Healthcare's recent decision to drop several hundred doctors from its Medicare Advantage plan means for the 36,0000 or so Rhode Islanders in that plan. Following is a transcript of their conversation, and a link to listen.

The Rhode Island Medical Society said United Healthcare has cut hundreds of doctors from its Medicare Advantage network. The plan covers some 36,000 Rhode Island seniors.

Rhode Island Attorney General Peter Kilmartin and Health Department director Michael Fine have sent a letter to the CEO of United Healthcare New England expressing their concern over the insurer’s dropping of dozens of doctors from its managed Medicare plan in the state. They want United to reinstate doctors until they submit a plan to handle the transition.

Wikimedia Commons

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.

You may have heard about United Healthcare's decision to cut a number of doctors from its Medicare Advantage plan in Rhode Island and some surrounding states. That means that, for some seniors, their doctor may no longer be considered "in network" - and, therefore, no longer affordable for some, since "out of network" doctor visits cost more.

Rhode Islanders who are covered by both Medicare and Medicaid - the so-called "dual eligibles" - take note: you're being enrolled in a new health plan designed to coordinate your primary care and long term care needs a bit better. It's called the Integrated Care Initiative, it could affect nearly 28,000 Rhode Islanders, and it's not without controversy.

But first, what's it about?

Centers for Disease Control and Prevention

Opioids are narcotic painkillers, and they include popular drugs with brand names like OxyContin, Vicodin, and Demerol. Heroin is another. And while the former have eased the pain of many, all of these drugs are potential killers. They're incredibly addictive. And prescription drug overdose deaths, according to what many health care providers and experts tell me, have reached epidemic status in Rhode Island.

You may have heard news yesterday that the federal government has released a greater level of detail on the prices hospitals charge for a list of common procedures and how widely those prices vary - not only from state to state but within states, and  even within the same city. The data comes from the Centers for Medicare and Medicaid Services (or CMS), from 3000 hospitals nationwide.

In last night's State of the Union address, President Barack Obama mentioned health care five times (by my count). One, later in the address, referred to making sure military veterans get the mental health care they need. The other mentions had to do with Medicare: as the nation ages, it's the biggest contributor to our nation's deficit.

Here's what he said:

This morning, you might have heard the next in our Future Docs series, which looks at a projected doctor shortage and how graduate medical education funding could staunch or deepen that shortage.

Senator Sheldon Whitehouse
RIPR File

Sen. Sheldon Whitehouse (D-R.I.) published an op-ed on Politico Tuesday urging President Obama not to agree to any Medicare cuts in the fiscal cliff negotiations. The reason: reforming the health care system, including the way we deliver and pay for health care, will add up to all the savings we need.

Whitehouse writes:

A new study in the journal Academic Medicine provides one of the first looks at a program created by the Affordable Care Act in 2010 to train more primary care doctors. It’s a pretty different model than the traditional one, where the government, through Medicare, makes payments to teaching hospitals to help fund graduate medical education (like a residency program for doctors-in-training).

The Association of American Medical Colleges has launched a new ad campaign, running in newspapers near the sites of upcoming presidential debates, calling for an increase in funding for graduate medical education. The group is trying to draw attention to what it sees as a crisis in the making: the current limit on the number of federally funded residency programs could, it says, lead to doctor shortages. It's just the latest in a series of movements on the GME front.

As part of his effort to separate himself from congressional Republicans, Brendan Doherty held a news conference outside Memorial Hospital in Pawtucket this morning. He offered what his campaign calls, via news release, an “ironclad pledge”:

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