Dive Brief:
- A federal appeals court has ordered UnitedHealthcare to go into mediation with the Fairfield County Medical Association and the Hartford County Medical Association over the payer's decision to drop 2,200 doctors from its Medicare Advantage program.
- The medical associations had filed suit against UnitedHealth, claiming that the payer is violating federal law by cutting the physicians from its network without cause and without the ability to appeal the decision.
- In a hearing last week, a three-judge panel left the injunction against UnitedHealth in place, and ordered all parties into the court's Civil Appeals Management Plan. CAMP, which is usually used before the court hears arguments, is a mediation process overseen by a court-appointed attorney.
Dive Insight:
This is far from the last time we will see physicians' groups in court fighting network reductions by payers. When reimbursement goes down -- and Medicare Advantage reimbursement was cut 6.5% last year -- payers to have to respond. With the ACA policies designed to be as inexpensive as possible, that, too, will motivate payers to cut back their networks. In fact, this could be the year of the big physician network reduction. It will be interesting to see whether doctors can get any traction in fighting back when this happens to them.