Law360 interviewed Manatt's Joel Ario, a managing director with Manatt Health, for an article about the increase of lawsuits filed by doctors and patients over downsized provider networks inspired by the Affordable Care Act.
Law360 reports that in one notable complaint, 2,000 Connecticut physicians sued UnitedHealth Group after the insurer tried to boot them from its Medicare Advantage network without explaining its reasons for doing so, ultimately winning an injunction that sent the disputes to arbitration. Industry insiders are predicting that more litigation will arise as more policyholders eventually need medical care and discover that access is more limited than expected, and regulators are already taking notice. Observers say that the trend recalls the 1990s push toward managed care policies that also imposed tight limits on the doctors patients could see.
A repeat of that situation could derail network restrictions that are "critical to price and quality competition and fully intended by the ACA," said Ario.
"Frankly, I worry that a few bad consumer horror stories could provoke an overreaction on the regulatory side," Ario said.
Read the article here.