In recent months I have had a number of physician clients contact me to tell me that they have unexpectedly been dropped from one or more Medicare Advantage plans with which they have participated with no issue for, in some case, years. These physicians are left somewhat bewildered because these terminations are being done without cause and without explanation. A recent article on cnn.com (Docs say insurers dropping them in hopes their costly patients follow) perhaps offers an explanation for these abrupt terminations, and highlights what may be another unintended consequence of Affordable Care Act. At least according to some accounts, plans may be dropping network providers as a means of weeding out high cost patients. Many physicians and providers I work with have become complacent with the managed care environment, in many cases accepting participation agreements without even reviewing them or considering the consequences for their practices. Although it will take a long time for all of bugs and kinks of the Affordable Care Act to come to light, one certainty is that managed care companies are proactively taking steps to minimize their own exposure under the law. Consequently, physicians and other providers should be paying close attention to their managed care arrangements in the months to come.