ROSELAND, N.J., Oct. 16, 2019 (GLOBE NEWSWIRE) -- Steven I. Adler and Mohamed H. Nabulsi of Mandelbaum Salsburg P.C. in Roseland, NJ, filed an emergent application in federal court in Newark, NJ, on behalf of The Medical Society of New Jersey (MSNJ) and various inner-city medical groups against UnitedHealthcare (UHC) to enjoin and restrain UHC from terminating healthcare providers from its NJ Medicare Advantage Community Health Insurance Plan and to stop UHC from misrepresenting that these providers are no longer accepting new patients.
UHC sent letters terminating what is believed to be hundreds of NJ medical providers, advising them that they will be removed from its Medicare Advantage (MA) network over the next few months when their contracts expire. No reason was given to these providers and UHC acknowledged that they are being terminated “without cause.” UHC also sent letters to thousands of patients informing them that their doctors are being dropped from the MA network and reassigning these patients to other UHC providers, even before their terminated providers exhaust their right to appeal UHC’s decision.
“UHC’s attempt to terminate these medical providers 'without cause' and interfere with thousands of physician-patient relationships involving elderly and poor patients is especially troubling given President Trump’s recent executive order expanding Medicaid and Medicare coverage through private, for-profit, insurance companies,” said Steven Adler. “If the power of MA organizations, like UHC, is not judicially checked through private litigation like our lawsuit, the expansion contemplated by the Executive Order will only enable MA organizations to adversely affect a greater number patients/providers through its profit-driven actions,” added Mohamed Nabulsi.
On October 4, 2019, Mr. Adler and Mr. Nabulsi achieved a significant court victory. Federal court judge Kevin McNulty granted plaintiffs’ request for a temporary restraining order, directing UHC not to terminate the doctors or medical providers in the lawsuit from its MA Plan and to remove any indication that these providers will be dropped from the Plan upon the expiration of their contracts. The Court’s order enables these physicians’ patients to choose to remain with their medical providers once the open enrollment period begins on October 15th.
“UHC's decision to drop these doctors will result in tens of thousands of patients losing their primary care physicians and specialists, some of whom they have been seeing for years, which will interfere with their medical care,” said Dr. Alexander Salerno, a primary care doctor with Salerno Medical Associates in Newark and East Orange, NJ and a plaintiff in the complaint. “Meanwhile inner-city medical groups, which cater to elderly and poor Medicare and Medicaid patients, would likely shutter, leaving a healthcare void for this underserved population,” he added.
The dispute now moves to the American Arbitration Association where the MSNJ will argue that any purported terminations must be reversed and that doctors who UHC wishes to remove from the Plan must be afforded their due process rights to an appeal hearing before any such removal can occur, followed by arbitration or court should a doctor wish to further challenge the action.
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