UnitedHealthcare sent letters to Medicare Advantage plan members in Rhode Island. The letters said they may lose coverage at certain hospitals starting July 1. This will happen if UnitedHealthcare and the hospitals do not reach a new contract agreement.
The hospitals affected are Hasbro Children’s, Newport, Miriam, and Rhode Island Hospitals. Physicians at these hospitals would still be covered. A spokesperson for the hospitals said they asked UnitedHealthcare for a small rate increase.
They also wanted the insurer to remove some policies that differ from traditional Medicare. These include prior approvals that can frustrate patients and add costs. Since both sides did not change their positions, they decided to end the hospital contract on June 30.
Changes to Medicare hospital network
If no agreement is reached, UnitedHealthcare Medicare Advantage members may pay more at these hospitals. UnitedHealthcare hopes to reach an affordable long-term agreement.
They want to keep offering competitive benefits to Medicare Advantage members. Saint Anne’s and Morton Hospitals in Massachusetts are not affected by this contract issue. UnitedHealthcare’s stock price has fallen a lot recently.
The Department of Justice is investigating the company for possible Medicare fraud. The current hospital agreement lasts until June 30. UnitedHealthcare is trying to renew the relationship.
If they cannot agree, the hospitals will be out-of-network for Medicare Advantage plans on July 1.
