UF Health, United Healthcare fail to reach deal before deadline. UF Health now out of network for United patients

JACKSONVILLE, Florida. – The deadline set for UF Health and United Healthcare to reach a new agreement passed on Sunday, but no agreement was reached.

This means UF Health is no longer a provider within the United Healthcare network.

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Abbie, a UF Health patient who did not want her last name used for privacy reasons, told News4JAX she has become dependent on UF doctors after undergoing neck surgery there earlier this year.

“These doctors performed major surgery, they did tricks. They know everything that’s happening to me,” she said.

Abbie said she was surprised to learn two weeks ago that an appointment she had scheduled for next month would be canceled because UF Health would not accept United Healthcare insurance after Sept. 1, and three other appointments were subsequently canceled.

“What should I do?” she asked.

She told News4JAX she can’t afford to pay out of pocket and doesn’t want to look for new suppliers.

“UF has given me the best care and I don’t want to go anywhere else. These doctors know me, they know my conditions,” Abbie said. “I don’t want to go anywhere else. I can’t. I trust them too much.”

UF Health Jacksonville is a safety-net hospital, and rating agency Fitch Ratings said it had an operating loss of $83 million last year.

Meanwhile, UnitedHealth Group’s profits will reach $22 billion in 2023.

On Sunday, after the deadline passed, UF Health issued a statement that read, among other things:

Despite months of honest, good faith negotiations to obtain fair and appropriate rates for hospitals, physicians and other providers, United Healthcare is excluding UF Health hospitals and physician groups in Gainesville, Jacksonville and St. Johns from its network as of September 1. This action denies thousands of patients with United Healthcare Commercial and Medicaid Managed Care plans access to compassionate, state-of-the-art care at UF Health facilities in all three markets, as well as Medicare Advantage patients in the St. Augustine area.

“We are sensitive to the challenges this creates for our patients and, despite the outcome, continue to work diligently with United Healthcare to find a solution. Our commitment to putting patients at the center of our efforts is unwavering and we have implemented processes to minimize any disruption to care to the extent possible, but unfortunately United Healthcare has given us no other choice,” said Marvin Dewar, MD, JD, CEO of UF Health Physicians. “We even invited United’s leadership to meet with us on-site to finalize the agreement, but they declined. We continued to try to reach an agreement right up until the deadline, but United insisted on tying other products into the negotiations and abruptly imposing new terms and changing language on items that had already been agreed to. As a physician, my job is to care for my patients and we have done everything we can to avoid this situation.”

UF Health

To read UF Health’s full statement, Click here.

United Healthcare posted the following statement on its website:

University of Florida Health (UF Health) is no longer in-network for individuals enrolled in the following plans (as of September 1, 2024):

UF Health Psychiatric Hospital and UF Health Central Florida have separate agreements and are not part of our negotiations. They are still in our network.

Only UF Health St. John’s – Flagler Hospital and its physicians are no longer covered by Medicare Advantage plans as of Sept. 1

These negotiations do not impact Medicare Advantage plans or our Dual Special Needs Plans (DSNP) at other UF Health hospitals and professional provider locations across the state, including, but not limited to: UF Health Gainesville, Jacksonville, Leesburg, or The Villages Regional Hospital. They will continue to be in the UnitedHealthcare network for our Medicare Advantage plans as of September 1.

United Healthcare

To read United Healthcare’s full statement, including frequently asked questions, Click here.

United Healthcare previously assured its members that other doctors and hospitals in the area would remain in the 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 continuing care.

“Our top priority is ensuring that the Florida families we serve have access to the care they need. In the event that UF Health leaves our network, UnitedHealthcare members who are receiving care from a UF Health provider may be eligible for continuing care, which provides ongoing benefits within the network for a specified period of time after a hospital or physician leaves our network. Here are some examples of patients who may qualify:

• Pregnant women.

• Patients with newly diagnosed cancer or relapsed cancer, as well as patients currently undergoing active cancer treatment.

• Transplant recipients who require ongoing care due to transplant-related complications.

• Members who have questions about continuity of care or alternative hospitals in their area should call the number on their health plan identification card.

• Members can also use the provider directory at myuhc.com to find other hospitals in their area.

In the event of an emergency, UnitedHealthcare members should go to the nearest hospital. Services will be covered at the in-network benefit level, regardless of the hospital’s network status.”

United Healthcare

According to a statement from UF Health, the company will continue to participate in the traditional Medicaid program but will enter into a provider collaboration agreement only with the Medicaid Manager Care health plans listed in this fact sheet.

If you have any questions, please contact UF Health at 352-265-8585 or toll-free at 1-855-834-7337. You can also find more information on this website.

Baptist and Florida Blue

UF Health and United Healthcare are not the only ones facing contract negotiation issues that could impact thousands of patients.

Florida Blue, the state’s largest health insurer, could soon be rejected from Baptist Health facilities if the two sides can’t negotiate a new contract. The deadline is Sept. 30.

MORE | Florida Blue, Baptist Health have 1 month to negotiate new contract

The two sides have been negotiating since February but have not reached an agreement.

If the parties do not reach an agreement before October, Baptist will be deemed out-of-network for thousands of patients, making health care unaffordable for many.

Baptist Health said in a statement:

We continue to negotiate in good faith. We met with Florida Blue yesterday (Thursday) and at our request Florida Blue agreed to add a third meeting in September to the two already scheduled.

Patients can find answers to their questions at baptistjax.com/florida-blue and floridablue.com/negotiation/baptisthealthjax.