Bloomberg BNA’s Health Law Reporter Quotes Partner Thomas Jeffry on Ramifications United Healthcare Decision

Partner Tom Jeffry was quoted in Bloomberg BNA’s Health Law Reporter article on a recent Federal Trial Court decision to enjoin United Healthcare from removing certain physicians from its Medicare Advantage (MA) network.

“‘The opinion, and its thinking, which will be replicated throughout the land like kudzu, concern fairness and physician-patient relationship values that are at odds with what many would view as the essence of the ACA and, for that matter, the evolution of health care delivery systems over the past 30 years,’’’

Mr. Jeffry added “the court’s holding in the case, that a unilateral action by a health plan to terminate a physician contract disrupts the physician-patient relationship sufficient to grant injunctive, equitable relief, is both novel and significant. ‘Although the case deals with Medicare Advantage contracts and the court infers that elderly Medicare patients may be more vulnerable, it is not clear that the holding or the reasoning would only apply in the Medicare managed care context.’”

“The court seemed to reason that termination of any physician contract, even those for good cause, will be disruptive to the patients of that physician. ‘If extended, this could be a dangerous precedent if hospitals, employers, IPAs or other health organizations were precluded from terminating a physician contract without cause based on an allegation that such termination may harm the patients,’” Mr. Jeffry concluded.


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