JACKSONVILLE, Fla. – The deadline for UF Health and United Healthcare to come to terms on a new contract agreement passed Sunday without a deal being made.
That means UF Health is no longer an in-network provider with United Healthcare.
UF Health patient Abbie, who wanted to withhold her last name from publication for privacy reasons, told News4JAX she has depended on UF providers after she had neck surgery there earlier this year.
“These doctors did a major surgery, they did tricks. They know everything going on to me,” she said.
Abbie said she was surprised when she learned two weeks ago an appointment she had scheduled for next month would be canceled because UF Health wouldn’t accept United Healthcare insurance after Sept. 1, and then three other appointments were canceled.
“What am I going to do?” she asked.
She told News4JAX she doesn’t have the money to pay out of pocket and she doesn’t want to have to find new providers.
“UF has given me the best care, and I don’t want to go anywhere else. Those doctors know me, know my conditions,” Abbie said. “I don’t want to go anywhere else. I can’t. I got too much trust in them.”
UF Health Jacksonville is a safety net hospital, and Fitch Ratings reported it had an operating loss of $83 million last year.
Meanwhile, UnitedHealth Group profits hit $22 billion in 2023.
UF Health released a statement on Sunday after the deadline passed, which read, in part:
Despite months of earnestly negotiating in good faith for fair and appropriate rates for hospitals, physicians, and other providers, as of September 1, United Healthcare is excluding UF Health hospitals and physician groups in Gainesville, Jacksonville, and St. Johns from its network. The action prevents thousands of patients with United Healthcare commercial and Medicaid Managed Care plans from accessing compassionate, leading-edge care at UF Health locations in all three markets and Medicare Advantage patients in the St. Augustine area.
“We are sensitive to the challenges this poses for our patients and despite the outcome we continue to earnestly work with United Healthcare toward a solution. 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 Marvin Dewar, M.D., J.D., chief executive officer of UF Health Physicians. “We even invited United leadership to meet with us on site to finalize the agreement but they declined. We continued to try to reach an agreement right up to the deadline but United insisted upon linking other products to the negotiations and abruptly imposing new conditions and changing language to items that had already been agreed upon. As a physician, my job is to care for my patients, and we did our best to avoid this situation.”
UF Health
To read UF Health’s full statement, click here.
On its website, United Healthcare shared the following statement:
The University of Florida Health (UF Health) is now out of network for people enrolled in the following plans, as of Sept. 1, 2024:
UF Health’s psychiatric hospital and UF Health Central Florida are on a separate contract and are not impacted by our negotiation. They continue to remain in our network.
Only UF Health St. John’s – Flagler Hospital and its physicians are out of network for our Medicare Advantage plans as of Sept. 1
This negotiation does not impact Medicare Advantage plans or our Dual Special Needs Plans (DSNP) at other UF Health hospitals and professional provider locations throughout the state, such as but not limited to: UF Health Gainesville, Jacksonville, Leesburg or The Villages Regional Hospital. They continue to remain in-network with UnitedHealthcare for our Medicare Advantage plans on and after Sept. 1.
United Healthcare
To read United Healthcare’s full statement, including FAQs, click here.
Earlier, United Healthcare had assured its members that other physicians and hospitals in the area would remain in network, including:
• AdventHealth Palm Coast
• AdventHealth Palm Coast Parkway
• Ascension St. Vincents Riverside
• Ascension St. Vincents Southside
• Baptist Medical Center
• Baptist Medical Center-Beach
• Baptist Medical Center-Nassau
• HCA Florida Memorial Hospital
• HCA Florida North Florida Hospital
• HCA Florida Orange Park Hospital
• Mayo Clinic Florida
• Wolfson Children’s Hospital”
Some patients may also qualify for continuity of care.
“Our top priority is ensuring the Florida families we serve have access to the care they need. In the event UF Health leaves our network, UnitedHealthcare members who are in the middle of treatment with a UF Health provider may qualify for continuity of care, which provides continued in-network benefits for a specified period of time after a hospital or physician leaves our network. A few examples of patients who may qualify include:
• Women who are pregnant.
• Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.
• Transplant recipients in need of ongoing care due to complications associated with a transplant.
• Members who have questions about continuity of care or alternative hospitals in their area should call the number on their health plan ID card.
• Members can also use the provider directory at myuhc.com to search for alternative hospitals in their area.
In the event of an emergency, UnitedHealthcare members should go to the nearest hospital. The services will be covered at the in-network benefit level, regardless of the hospital’s network status.”
United Healthcare
According to UF Health, it will continue to participate in the traditional Medicaid program but will have a participating provider agreement with only the Medicaid Manager Care health plans listed on this information sheet.
For questions, people are asked to call UF Health at 352-265-8585 or toll-free at 1-855-834-7337, or visit this website for more information.
Baptist & Florida Blue
UF Health and United Healthcare are not the only ones having issues with contract negotiations that could impact thousands of patients.
Florida Blue, the state’s largest health insurer, may also soon be rejected at Baptist Health facilities if the two can’t negotiate a new agreement. The deadline is on Sept. 30.
MORE | Florida Blue, Baptist Health have 1 month to negotiate new contract
The two sides have been at it since February but have not agreed to a deal.
If the parties can’t reach an agreement before October, Baptist would be considered out-of-network for thousands of patients, making care unaffordable for many.
In a statement, Baptist Health said:
We continue to negotiate in good faith. We met with Florida Blue yesterday (Thursday) and at our request, Florida Blue has agreed to add a third meeting in September to the two that were already scheduled.
Patients can find answers to their questions at baptistjax.com/florida-blue and at floridablue.com/negotiation/baptisthealthjax.