warns hospitals about Envision ER contracts
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[September 25, 2018]
By Caroline Humer
NEW YORK (Reuters) - UnitedHealth Group Inc
will treat emergency room and other hospital services performed by
Envision Healthcare as out-of-network claims beginning next year after
failing to reach a new contract agreement with the staffing company,
UnitedHealth said on Monday.
The health insurer sent a letter seen by Reuters to 300 hospitals
informing them of the decision on Friday.
The letter comes 90 days ahead of the Jan. 1 date for the
out-of-network switch, and after months of negotiations between the
two companies to solve disagreements over payment rates and other
financial incentives, UnitedHealth spokesman Stephen Shivinsky said.
Envision spokeswomen Kim Warth, in an emailed statement, said the
company has been negotiating in good faith with UnitedHealth, which
is making "egregious demands" for price cuts "that will force all of
our physicians out of network."
The letters contain data for one group in one market, not for
overall markets, she said, describing the information sent to
hospitals as misleading.
UnitedHealth first said it was considering terminating its contract
with Envision in April.
Envision also sued UnitedHealth earlier this year, saying it was not
paying its bills. That ended up in court-ordered arbitration, which
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Envision has agreed to be bought by KKR & Co for more than $5.5
billion in a deal expected to close in the fourth quarter.
UnitedHealth said in the letter that Envision is asking for payment
rates that are nearly 600 percent of the rates in the Medicare
program for seniors and the disabled and twice the average amount
paid for ER physicians according to the National Bureau of Economic
Envision said its goal is to have in-network relationships with
partner insurers "so that patients donít have to worry about
surprise bills caused by surprise gaps in coverage."
(Reporting by Caroline Humer; Editing by Bill Berkrot)
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