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Friday, July 19, 2024 | Back issues
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Doctors Sue United Healthcare for Bad Faith

BROOKLYN (CN) - A 22,000-member physicians' group sued United Healthcare Insurance, claiming the money-grubbing, multibillion-dollar insurance company is illegally terminating them from its Medicare network on Jan. 1 to cut its losses from reduced federal payments under the Affordable Care Act.

The Medical Society of the State of New York sued United Healthcare Insurance Co. and three of its affiliates, in Federal Court.

United in September notified many of the plaintiff's doctors, and doctors in other states, that it was kicking them out of the Healthcare Insurance Medicare Advantage Network effective Jan. 1, 2014, the Society says in the lawsuit.

United claimed, disingenuously, that this unilateral boot was simply a way to "amend" the contracts, the Society says.

"Although no reason was provided for this unilateral termination, United's motives are nevertheless clear: By terminating numerous physicians from the MA Network, United seeks to stem financial losses occasioned by reduced federal payments under the Affordable Care Act," the complaint states. "This, of course, comes at the expense of the physicians, who[m] United otherwise retains as a participating provider in its other plans, and the patient communities that they serve."

This will hurt the elderly patients and the doctors, the Society says. It claims the abrupt severing of doctor-patient relationships "will shift the geriatric population to a crisis-oriented culture which further impacts the health and safety of Medicare beneficiaries and increases the cost of the health care, a situation that the Affordable Care Act was meant to address."

It also belies United's "repeated and explicit commitments to improving their provider networks," the doctors claim. "What United instead is doing is shifting the financial Burdens imposed by the Affordable Care Act from itself, a multibillion-dollar company, to the providers and patients, all with the aim of maximizing revenues. Such a bad faith response, which undermines clear legislative policies and is being done solely for the sake of profits, cannot be condoned."

The Society wants United Healthcare enjoined from its threatened termination, which it claims was done in violation of Medicare and Medicaid regulations.

The doctors are represented by David Adelson, with Kern, Augustine, Conroy & Schoppmann, of Westbury, N.Y.

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