Thousands of UnitedHealthcare members in central Florida could soon lose access to Orlando Health’s in-network care due to a deadlock in contract negotiations.
United’s contract with Orlando Health’s doctors and hospitals expires on July 31st, and if the groups do not reach an agreement by then, people enrolled in the following plans beginning August 1st: Most services no longer apply. Medicare Advantage, including Group Retiree PPO Plans. Medicaid, including the Dual Special Needs Plan.
With less than two weeks remaining after months of negotiating new terms, both sides have accused the other of delaying negotiations, making misleading statements about negotiations and making unreasonable offers.
United Healthcare recently sent a letter to nearly 74,000 members who were treated through Orlando Health, warning them they were in danger of losing access to treatment. Orlando Health also wrote to patients, suggesting they call United and urge them to expedite negotiations.
United spokesman Cole Manbeck said in a statement Tuesday that Orlando Health is pushing up members’ premiums and out-of-pocket costs, proposing a significant rate increase that will cost local businesses millions of dollars in medical bills. issued a statement.
“We are proposing a rate increase that will ensure Orlando Health continues to be reimbursed fairly and appropriately. We urge Orlando Health to join the negotiating table and provide a realistic offer affordable to families and employers in Florida.” written in the statement.
United Airlines has identified reimbursement rates as a key issue in the negotiations. Michele Napier, senior vice president and chief revenue officer of Orlando Health, said Orlando Health is battling disagreements over reimbursement rates, as well as certain policies at United Airlines that make it difficult to treat patients. said there is.
United Airlines rejects charges more often than other payers, she said.
“Rates are important, but United Healthcare’s policies are unfair to patients and doctors alike,” Napier said. “…they have the worst behavior of any healthcare program in terms of denials, policies and pre-approval.”
Both United Healthcare and Orlando Health are committed to meeting with each other as often as necessary to reach new agreements by the deadline, and as long as the 20-year partnership continues, a top priority will be It said it was a continuation of care for vulnerable patients. expire.
“We are going to have a conversation with United to resolve this issue. We are asking reasonably. It is natural that we want policy changes. I’m going to spend as much time as I want,” Napier said.
United’s website states that emergency medical care will continue to be covered even after Orlando Health’s partnership with United ends. Additionally, people currently undergoing treatment for a serious medical condition, such as cancer, or who are pregnant can apply for continued treatment insurance on United’s Orlando Health website, he said. It is
But many other Central Florida residents may need to find a new doctor. Orlando Health is her second largest healthcare chain in the area, after Advent Health Central Florida. Orlando’s healthcare system has 29 hospitals and emergency departments, employing more than 1,200 doctors.
This worst-case scenario has happened many times in Florida.
In 2022, United Health Care members in South Florida lost six months of coverage in the Broward Health Care Plan after the health system and insurers failed to renegotiate new contracts, leaving thousands to seek treatment elsewhere. or forced to continue seeing doctors outside the network until 2020. A new contract was agreed, The South Florida Sun Sentinel reported in November.
United Healthcare Plan members stay within the network of other local hospitals, including HCA, Nemours and AdventHealth.
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