UnitedHealthcare could face potential federal fines for allegedly creating misleading advertisements touting its Medicare Advantage plan.
Democratic Sen. Richard Blumenthal said the ads, targeting elderly, low-income and disabled adults, described added benefits, but instead actually restricted access to care.
“UnitedHealthcare lured thousands of Connecticut patients by this deceptive and misleading advertising,” Blumenthal said.
The ads, which ran in local newspapers throughout the state, stated applicants could get additional benefits not included with regular Medicaid and Medicare plans.
Blumenthal, who spoke at the state Capitol building in Hartford on Tuesday along with Disability Rights Connecticut litigation attorney Sheldon Toubman, said 94,000 signed up statewide in 2023 for a plan that ended up limiting their in-network providers, and added requirements to clear procedures.
They’re not only advocating for government intervention, but want the company to allow people to leave the plan.
Blumenthal said the plan’s disadvantages outweighed its benefits.
“They'll be told, ‘Oh, we don't take Medicare Advantage, sorry, you have to go to a new doctor,” Blumenthal said.
Toubman said his group is focusing on representing dually eligible people, which are adults who qualify for both Medicare and Medicaid.
He discussed dental and vision coverage as an example. Traditional Medicare and Medicaid do not cover many routine dental procedures like filings, or dentures.
The plans, which the ads said offer dental coverage, didn’t include the potential risks with getting a plan, such as more barriers to procedure authorizations, he said.
“Shouldn't they be told that if you're in Medicare Advantage, there's now this restrictive prior authorization,” Toubman said.
UnitedHealthcare responded in a statement pushing back against the allegations.
"These allegations are completely baseless," UnitedHealthcare said. "All UnitedHealthcare DSNP plans in Connecticut allow members to see any provider that accepts Medicare, and they offer better benefits when compared to Medicaid alone, including enhanced dental and vision benefits and a monthly healthy food, OTC and utilities credit. Our plan benefits are filed and approved by CMS and our advertising factually describes these benefits and is filed in accordance with CMS guidance."
While Medicaid does offer additional aid for income-restricted adults, dental is only available for children, meaning those with dual plans would need to pay out of pocket. Medicare Advantage essentially acts as supplementary coverage, run by a private company.
Blumenthal and Toubman aren’t alone. The American Hospital Association recently released a letter calling on the Medicare Payment Advisory Commission (MedPAC) to collect data on Medicare Advantage denials.
The letter also referenced a 2022 Department of Health and Human Services study showing people under Medicare Advantage plans saw higher denial rates compared to regular Medicare plans.
Blumenthal called on the government to fine the company. But he’s also calling on UnitedHealthcare to do right by the 94,000 people who signed up for the plan.
“That is what we are asking. And that retroactively, those ... people who have been lured away from their traditional Medicare and Medicaid plans, be given the option to switch back.“
