United Healthcare, UF Health fails to agree on a contract before September deadline, thousands affected

JACKSONVILLE, Fla. — University of Florida Health (UF Health) and United Healthcare have failed to resolve their months-long contract negotiations, resulting in the expiration of their agreement on Sunday. This development has left thousands of patients across the First Coast without a network provider, worsening ongoing healthcare challenges in the region.

>>> STREAM ACTION NEWS JAX LIVE <<<

As of September 1, United Healthcare is excluding UF Health hospitals and physician groups in Gainesville, Jacksonville, and St. Johns from its network.

According to UF Health, United Healthcare no longer covers UF Health physicians, hospitals, and other facilities for commercial and Medicaid Managed Care health plans in Gainesville and Jacksonville. Additionally, patients covered by United Healthcare’s Medicare Advantage plans will no longer have access to physicians with UF Health St. Johns or Flagler Hospital.

UF Health Jacksonville, a safety net hospital, reported an $83 million operating loss last year, according to Fitch Ratings. In 2023, UnitedHealth Group’s profits reached a reported $22 billion.

However, this exclusion does not impact Medicare Advantage plans or Dual Special Needs Plans (DSNP) at UF Health locations in Jacksonville, Gainesville, and Leesburg, according to United Healthcare.

United Healthcare claims that it had agreed to terms with UF Health regarding its Medicaid network but alleges that UF Health did not respond to finalize the contract on August 31, disrupting access for approximately 30,000 people enrolled in Medicaid plans.

The lack of a contract will also affect patients enrolled in employer-sponsored commercial plans and those covered by UF student health insurance plans. Despite this, UF Health’s psychiatric hospital and UF Health Central Florida remain under separate contracts and will continue to be included in United Healthcare’s network.

“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 UF Health Physicians Chief Executive Officer Marvin Dewar in a news release.

RELATED: UF Health Jacksonville $83M in operating losses; financial outlook downgraded by rating agency

Dewar further explained that UF Health had invited United Healthcare to meet and finalize an agreement, “but they declined” and “insisted upon linking other products to the negotiations and abruptly imposing new conditions and language on items that had already been agreed upon.”

United Healthcare provided a different account, claiming that UF Health’s last proposal, sent on August 29, included demands for a 30% price hike over the next two years, with more than a 20% rate increase in the first year. On August 30, United Healthcare sent back a counterproposal that included additional rate increases on top of what had already been proposed. According to United Healthcare, UF Health never responded to this last proposal and allowed the contract to expire.

The two entities have been negotiating for months over reimbursement rates, with UF Health arguing that United Healthcare offered commercial rates below general inflation and “far below annual costs.”

Dewar emphasized the importance of fair compensation, stating, “We deserve to be paid fairly and competitively for the care we provide to patients and the services we offer. Reasonable compensation is necessary for us to sustain our mission.”

Both UF Health and United Healthcare confirmed they are “committed” to continuing negotiations. United Healthcare has urged UF Health to rejoin them at the negotiating table, while UF Health says it is negotiating in good faith but is awaiting a fair and sustainable offer.

Patients affected by the contract expiration are encouraged to contact UF Health with questions at 1-855-834-7337 or 352-265-8585. For more information on frequently asked questions, visit https://UFHealth.org/healthplans.

United Healthcare patients can also contact the following customer service numbers for assistance:

• Commercial: 1-866-801-4409
• Medicaid Managed Care: 1-888-716-8787
• Medicare Advantage: 1-855-893-5505

[SIGN UP: Action News Jax Daily Headlines Newsletter]

Click here to download the free Action News Jax news and weather apps, click here to download the Action News Jax Now app for your smart TV and click here to stream Action News Jax live.