JACKSONVILLE, Fla. — University of Florida Health and United Healthcare failed to resolve monthslong contract negotiations, leaving thousands of First Coast patients without a network provider on Sunday.
The contract between UF Health and United Healthcare expired Sunday.
UF Health said in a news release Sunday that United Healthcare is excluding UF Health hospitals and physician groups in Jacksonville, St. Johns and Gainesville from its network.
United Healthcare is no longer covering UF Health physicians, hospitals and other facilities for commercial and Medicaid Managed Care health plans in Gainesville and Jacksonville, according to UF Health.
Patients covered by United Healthcare's Medicare Advantage plans will no longer have access to physicians with UF Health St. Johns or Flagler Hospital as of Sept. 1. This does not impact Medicare Advantage plans or Dual Special Needs Plans (DSNP) at UF Health Jacksonville, UF Health Gainesville and UF Health Leesburg, according to United Healthcare.
UF Health Physicians Chief Executive Officer Marvin Dewar said the providers are working with Medicaid patients to limit provider changes and find ways to keep costs low.
“We are going to find a way to continue to see those Medicaid patients who need to be seen even though we are out of network," Dewar told First Coast News on Monday. "For patients who have commercial United Insurance, it's a little more complicated. We are out of network for that."
United Healthcare said it agreed to terms with UF Health regarding its Medicaid network, but claims UF Health never responded to finalize the contract on Aug. 31, disrupting access for 30,000 people enrolled in Medicaid plans.
A lack of contract between the two entities will also affect patients enrolled in employer-sponsored commercial plans. UF Health's psychiatric hospital and UF Health Central Florida are under separate contracts and will remain on United Healthcare's network, officials said.
UF students who have a United Healthcare plan through the school's student health insurance program will be able to continue receiving care at the UF Student Health Care Center and all UF Health facilities as they always have.
"Our commitment to placing patients at the heart of our efforts is unwavering, and we have put processes in place to minimize any disruption in care to the extent we can, but unfortunately United Healthcare has given us no other choice," said Dewar in a news release shared on Sunday.
Dewar claims UF Health invited United Healthcare to meet and finalize an agreement, "but they declined" and "insisted upon linking other products to the negotiations and abruptly imposing new conditions and language on items that had already been agreed upon," the release states.
United Healthcare claims UF Health's last proposal was sent on Aug. 29, and included demands for a 30% price hike over the next two years, with more than 20% rate increase in the first year. On Aug. 30, United Healthcare sent back a counter that included additional rate increases on top of what was already proposed, according to United Healthcare officials.
"All of our proposals ensured UF Health would be reimbursed at rates similar to their peers in the market. UF Health never responded to our last proposal and allowed our contract to expire," United Healthcare said Sunday.
The two entities had been negotiating for months over reimbursement rates, with UF Health arguing United Healthcare offered commercial rates below general inflation and "far below annual costs."
"We deserve to be paid fairly and competitively for the care we provide to patients and the services we offer," Dewar said. "Reasonable compensation is necessary for us to sustain our mission."
Both UF Health and United Healthcare confirmed they are "committed" to continuing negotiations.
"However, we need UF Health to join us at the negotiating table," United Healthcare said.
"We are continuing to negotiate in good faith but we are waiting for the health plan to respond with a fair and sustainable offer to make that happen. Again, this includes streamlining their claims process and reducing administrative demands," UF Health said.
Patients can contact UF Health with questions at 1-855-834-7337 or 352-265-8585. For more information on frequently asked questions, visit https://UFHealth.org/healthplans.
United Healthcare patients can contact the following customer service numbers:
- Commercial: 1-866-801-4409
- Medicaid Managed Care: 1-888-716-8787
- Medicare Advantage: 1-855-893-5505