Dive Brief:
- Legislation was reintroduced Wednesday by Sens. Sherrod Brown (D-OH) and Richard Blumenthal (D-CT) aiming to prevent Medicare Advantage insurers from dropping doctors from their networks mid-year, forcing patients to try to change providers or pay out-of-network rates.
- The bill would also require plans to finalize their networks 60 days prior to the Medicare annual open enrollment period, which begins next week for 2016.
- “We know this happens in Ohio and across the country far too often,” Brown stated. “Seniors should know their doctors will be covered all year long.”
Dive Insight:
This is the second attempt for the bill by Brown and Blumenthal. It was first introduced last year, along with a House version by Rep. Rosa DeLauro (D-CT)
The issue gained notoriety in Connecticut last year, Modern Healthcare notes, after UnitedHealthcare dropped a high volume of providers from its Medicare Advantage plans, including those of the Yale-New Haven Hospital system, resulting in a legal dispute. The scenario of trimming networks after enrollment ends is not uncommon, it adds.
The reintroduced legislation follows a recent Government Accountability Office (GAO) report that said CMS needs to look closer at whether Medicare Advantage plans are providing sufficient provider networks, as well as consider the availability of the listed providers and confirm the accuracy of listed provider information.