May 27, 2024

Orlando Health patients face losing insurance coverage amid contract breakdowns

ORANGE COUNTY, Fla. – A strained network contract negotiation between United Healthcare and Orlando Health could mean a loss of coverage for scores of patients.

In an update earlier this month, insurance company United Healthcare announced that Orlando Health had delivered a proposal on June 30, which asked for a 24% price hike over the next year for its hospitals.

The update also states that the average cost of inpatient services at Orlando Health’s hospitals is higher than that of any other Central Florida health system affiliated with United Healthcare’s network.

United Healthcare said that it agreed to terms on Medicare and Medicaid, so the company proposed to Orlando Health to finalize the two contracts, meaning that those enrolled in either plan would continue to have access to Orlando Health.

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However, Orlando Health refused the proposal, “presumably because it hopes the potential disruption in care for these members will pressure us to give into the price hikes it’s seeking,” representatives from the company stated.

“Orlando Health is putting its most vulnerable patients in the middle of this negotiation, presumably in an attempt to pressure us to accept its demands for a 24% rate increase, potentially creating unnecessary and completely avoidable disruption in access to care for more than 30,000 Medicare Advantage and Medicaid members,” a statement from United Healthcare reads.

Should Orlando Health leave the company’s network, United Healthcare explained that customers enrolled in the Group Retiree PPO plan may still receive care from an Orlando Health physician or facility as an out-of-network provider if they are a Medicare-approved provider that accepts the plan. In that case, their share of the cost will be the same as though they were part of the network, United Healthcare added.

“Our goal is to reach an agreement without any disruption to the families we serve,” United Healthcare’s website reads. “We urge Orlando Health to join us at the negotiating table with a reasonable proposal that’s affordable and sustainable for the residents and businesses we serve throughout Central Florida.”

Orlando Health told News 6 that it was still working with United Healthcare to “negotiate a fair agreement.”

“As of today, critical elements remain open and a contract has not yet been reached. As caregivers of the community, Orlando Health is working tirelessly with patients and families to ensure their medical needs are met through continuity of care provisions. Orlando Health asks UHC to join us in putting patients first in ensuring continuity of care provisions are accommodating of all patients under the care of Orlando Health clinicians,” a statement from Orlando Health states.

The current contract agreement is set to expire after Monday.

In the case that a new agreement isn’t reached, United Healthcare is urging its customers to visit its website for information on next steps, including details about alternative healthcare facilities in the company’s network. You can find that information by clicking here.

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