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October 20, 2019Cart

Business

by Fairfield County Business Journal
by FCBJ

CT medical society protests Anthem axing specialists from network

Insurance giant Anthem has announced plans to terminate an unspecified number of Connecticut doctors from its Medicare Advantage Network – something that the state’s largest physicians association is vociferously opposing.

With the terminations set to begin on the first of the year, the Connecticut State Medical Society said it was concerned about how tens of thousands of Medicare Advantage patients would be affected. The cuts involve specialists, not primary care physicians.

In a letter to Anthem Blue Cross Blue Shield President Jill Hummel, the organization’s executive vice president Matthew Katz wrote that CSMS “has substantial concern that patients will face transportation hardships in reaching physicians in Connecticut, therefore significantly compromising patient care, if they can find a physician of the same specialty accepting new Medicare Advantage patients.”

“Further,” Katz continued, “CSMS is concerned that many of the physicians remaining in Anthem’s network are no longer accepting new patients (have closed panels) or are no longer practicing or practicing more limited specialty care so that specialized care needed by these patients is not available. In fact, a quick check of the Anthem website highlights this for many specialties, including ophthalmology.”

The letter went on to ask Anthem to specify how many physicians are being terminated; its rationale behind the selection of those being terminated; and whether patients have been notified of the terminations.

In a statement, Anthem did not address the first question, but noted, “We regularly review Anthem’s Medicare Advantage provider network to most effectively serve our members’ health care needs. We recently notified some specialty care providers that they will not be in our Medicare Advantage HMO Select Plan network, effective Jan. 1, 2020.

“We think it’s important that consumers are aware of this change so they can make informed decisions when considering Anthem’s 2020 Medicare Advantage plans,” it stated.