A dispute between UVM Health Network and an insurance company could leave thousands of people on the floor

BURLINGTON, Vt. (WCAX) – A dispute between our region’s largest health care provider and a health insurance company leaves nearly 3,000 patients in the lurch. This will not change unless UVM Health Network and UnitedHealthcare reach an agreement.

A letter has been sent to UnitedHealthcare commercial policyholders who have visited UVM Health Network facilities in Vermont and New York over the past year. It indicates that patients will be considered out-of-network if they visit a UVM facility because UVM overcharges the insurance company.

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

UnitedHealthcare released a statement saying, “Rapidly accelerating University of Vermont Health Care Network costs are neither affordable nor sustainable for residents and employers in Vermont and upstate New York. Our top priority is to renew our relationship with the healthcare system so that our members have continued access to affordable, quality care.

However, the UVM Health Network released a statement saying it planned to end its relationship with United on April 1, blaming administrative and operational issues at the insurance company. UVM’s statement reads, in part, “Despite our best efforts to address these issues, patients continue to experience unnecessary delays in approvals for routine tests, including imaging, treatments and medications, among many many other challenges.”

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

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

He says he struggled to find his doctor years ago when he moved to Malone and worries about the future of having to find another primary care provider.

“I have a primary care doctor that I trust and love and who I think has given me good care,” Little said.

It’s not official, the two parties still have until April 1 to agree. It does not affect Medicare, Medicaid, or the Veterans Community Care Network, which will remain in the network.

Copyright 2022 WCAX. All rights reserved.

About John Tuttle

Check Also

Nebraska hospitals provide $1.4 billion in community benefits each year

Nebraska hospitals provide a $15 billion boost to the state’s economy each year. That’s according …