Dispute between UVM Health Network, insurance carrier could leave thousands in the lurch

Published: Mar. 3, 2022 at 5:51 PM EST
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BURLINGTON, Vt. (WCAX) - A dispute between the biggest health care provider in our region and a health insurance company leaves nearly 3,000 patients in the lurch. That won’t change unless the UVM Health Network and UnitedHealthcare strike a deal.

A letter went out to UnitedHealthcare commercial insurance holders who visited UVM Health Network facilities in Vermont and New York during the past year. It says patients will be considered out of network if they visit a UVM facility because UVM is charging the insurance company too much.

UnitedHealthcare says negotiations have been going on for the past several months to renew the agreement that determines how much UVM Health Network hospitals charge for various patient procedures.

UnitedHealthcare released a statement saying: “The rapid acceleration of costs at the University of Vermont Health Network are not affordable or sustainable for the residents and employers of Vermont and northern New York. Our top priority is to renew our relationship with the health system so that our members have continued access to quality care that is affordable.”

However, the UVM Health Network released a statement saying they plan to end their relationship with United on April 1, blaming insurance company administrative and operational issues. The UVM statement says, in part, “Despite our best efforts to resolve these issues, patients continue to experience unnecessary delays in approvals for common tests, including imaging, treatments and medications, among many other challenges.”

Steven Little lives in Malone, New York, and uses the Alice Hyde Hospital in Malone, one of the hospitals in the UVM network. But now that he’s received a letter informing him his insurance will no longer work at Alice Hyde, he is looking at having to drive 45 minutes to an hour to another hospital still in UnitedHealthcare’s network.

“For my regular care, I would have to leave this area. I can’t even go to Plattsburgh because that is within the University of Vermont system,” Little said.

He says he had trouble finding his doctor years ago when he moved to Malone and worries about the future of being forced to find another primary care provider.

“I have a primary care physician who I trust and who I like and who I think who has been providing me with good care,” Little said.

This is not official, the two sides still have until April 1 to come to an agreement. This does not impact Medicare, Medicaid or Veterans Affairs Community Care Network, which will remain in-network.

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