United withdraws request for patient records in Connecticut
■ Physicians had received faxes from a UnitedHealth Group subsidiary, asking for patient diagnosis information.
By Emily Berry — Posted March 2, 2010
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Health Net, UnitedHealth Group and United subsidiary Ingenix said they have suspended efforts to collect medical records for Medicare Advantage members in Connecticut after hearing responses of confusion and skepticism from physicians.
United spokesman Daryl Richard said the records requests were part of reviews intended to "ensure the accuracy of patient diagnosis information" submitted to the Centers for Medicare & Medicaid Services by the companies' Medicare Advantage plans.
Matthew Katz, executive vice president at the Connecticut State Medical Society, said United, which recently acquired renewal rights to Health Net's membership in that state, had answered some but not all of physicians' questions about the records requests. In February the society asked the companies to explain the purpose of the requests, and the companies' authority to make them.
"We are still concerned that United and Health Net have initiated this kind of a broader chart review as a fishing expedition for other things they would come back and ask for later," Katz said.
The letters in question were faxed to physicians starting in December 2009 from Ingenix and contractor MediConnect. They asked physicians' offices to provide copies of medical charts for, in some cases, dozens of patients.
Health Net had hired Ingenix to collect records on its behalf before United acquired Health Net's membership, Richard said.
But because many were unfamiliar with either Ingenix or MediConnect's names, many physicians questioned the validity of the request, and ultimately, so did the CSMS.
United first responded by announcing it had suspended the chart reviews effective Feb. 5.
In a letter to the medical society sent Feb. 16, United and Health Net executives said both companies' physician contracts require doctors to comply with requests for medical charts.
Without apologizing, they said the company would work to improve the clarity of its communications with physicians and better explain the reasons for future chart requests, and also better explain the relationship between health plans and vendors they hire to do these reviews. United also gave a similar answer when CMS and Connecticut's Dept. of Insurance asked about the faxes.