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UnitedHealthcare accused of forcing doctors out of Medicaid system

UnitedHealthcare accused of forcing doctors out of Medicaid system

Second company chosen to manage Oklahoma’s program accused of wrongdoing

OKLAHOMA CITY, APRIL 6, 2021- Another of the insurance giants chosen to administer Oklahoma’s Medicaid program faces allegations of misconduct.

 

UnitedHealthcare has been sued in Colorado and Texas by U.S. Anesthesia Partners (USAP) for allegedly forcing USAP physicians out of UnitedHealthcare’s network and pushing hospitals to stop referring patients to USAP.

 

According to an article in The New York Times, the Texas lawsuit alleges UnitedHealthcare “engaged in ‘unlawful tactics and pressure campaigns,’ including ‘bribing’ surgeons with contracts that paid them much more if they steered patients away from the group’s anesthesiologists.

 

“The doctors make similar claims in the lawsuit they filed in Colorado, where they say United orchestrated a ‘group boycott.’ They describe United as ‘like a boa constrictor,’ squeezing the group ‘from all angles,’” the Times article states.

 

The Oklahoma Health Care Authority named UnitedHealthcare and three other insurance companies to administer the state’s Medicaid program beginning Oct. 1. Although the contracts involve more than $2 billion annually in state funds, the legislature was bypassed in the decision-making process.

 

“This is exactly what we fear will happen in Oklahoma,” said Todd Beasley, D.O., president of the Oklahoma Society of Anesthesiologists. “While forcing health care providers out of the system increases company profits, it also creates access-to-care challenges for patients. Fewer doctors, dentists, nurses and mental health professionals means longer wait times for care, especially in rural Oklahoma. We will not improve our state’s health outcomes by making it more difficult for patients to receive care. In fact, this would almost certainly worsen those outcomes.”

 

A second company set to take over Oklahoma’s Medicaid program, Centene Corp., faces allegations of fraud in Ohio and is under investigation for similar actions in Mississippi.

 

Ohio Attorney General Mike Yost filed a federal lawsuit saying Centene devised an elaborate scheme to maximize company profits at the state’s expense. The Ohio lawsuit, filed March 11, alleges Centene created a web of subcontractors to inflate pharmacy costs for Medicaid recipients. Mississippi’s attorney general is investigating similar allegations, according to media reports from that state.


To learn more about the Oklahoma coalition urging legislators to deny funding to this flawed privatization plan, go to www.healthcareholdup.com.