UF Health patients at risk of coverage loss in payer fight

Patients with the University of Florida Health system covered under UnitedHealthcare could lose coverage beginning Sept. 1, The Independent Florida Alligator reported Aug. 28. 

UF Health operates 12 hospitals and over 140 primary care practices throughout the state, and is waiting for UnitedHealthcare to respond with a "fair and sustainable offer" after months of contract negotiations. 

This includes streamlining claims processes and reducing administrative burdens, UF Health told the Alligator in a statement. UnitedHealthcare claimed in an Aug. 28 news release that UF Health is demanding a more than 25% price hike in the first year of its commercial contract. If an agreement is not reached by the end of August, thousands of patients across the state could experience a disruption in coverage.

The insurance company alleges that UF Health has repeatedly refused to finalize terms for Medicaid users amidst the negotiations over commercial rates. UnitedHealthcare covers 3.7 million people in Florida across 250 hospitals. The company posted over $370 million in annual revenue in 2023. 

"Insurers like UnitedHealthcare have reported billions in record profits while health systems like UF Health have shouldered growing costs while striving to fulfill the mission of serving patients and the community," UF Health said in its statement. 

UF students who receive UnitedHealthcare covered through the university's student health insurance plan will still be able to use UF Health facilities regardless of the outcome of the negotiations. 

Non-student patients who are insured through their employers or receive Medicaid will lose their coverage Sept. 1 if negotiations continue to stall. The only Medicare patients who will lose coverage are those at UF Health St. Johns, which joined the UF Health system last year. 

There are 64,000 people aged 65 and older in St. Johns County, and over 96% are covered under Medicare. Patients in the middle of a treatment, including pregnant people or newly diagnosed cancer patients, may qualify for continuity-of-care programs even if negotiations fail. These patients have until Sept. 30 to apply for continued coverage. 

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