Despite the termination of its contract with St. Joseph Health Care Services, UnitedHealthcare of New England says it will continue to allow its members to use the St. Joseph system facilities at no additional charge, as if it remained part of the UnitedHealthcare network.
The Catholic health care system – the nonprofit operator of Our Lady of Fatima Hospital and St. Joseph Hospital for Specialty Care – ended its contract with UnitedHealthcare on Sunday night, according to the insurer, “refusing a short-term contract extension that would have enabled us to continue negotiations without disrupting our members’ access to the hospital’s services.”
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St. Joseph officials gave a letter to UnitedHealthcare terminating the contract and requiring the insurer to notify the R.I. Department of Health of the situation, the insurer said. But while state officials review the matter, UnitedHealthcare said, subscribers will be able to seek care at the hospital as if nothing had changed.
In addition, UnitedHealthcare said, “we continue with negotiations, [and] we are trying to find common ground that will prevent higher costs for consumers and Rhode Island employers while providing access to the health care services needed.”
St. Joseph Health Services painted a different picture in a statement released today, saying it “will mount a vigorous and comprehensive effort to block plans by [the insurer] to drop the hospital from its provider network.”
The hospital system said its contract with UnitedHealthcare expired at midnight, after four months of talks and two contract extensions. Over the weekend, it said, “while the parties continued to exchange offers … United filed an application with the R.I. Department of Health to remove SJHS from its provider network.”
“We will not be bullied into accepting a reimbursement rate that is inadequate and unjust,” H. John Keimig, the hospital system’s president and CEO, said in the announcement.
“United is seeking to punish us for not agreeing to what we believe to be an a series of outrageous contract renewal offers,” Keimig said, adding: “All of United’s offers to us so far have been below our cost of providing care to patients.”
UnitedHealthcare said that during their contract negotiations two years ago, the hospital had requested – and received – “significant increases” in its reimbursement rates, but now the hospital is asking “for additional double-digit increases” the insurer said “would equal a 58-percent rise in reimbursement over four years,” including the last two years.
UnitedHealthcare also said the hospital “claims to be losing money serving Medicare patients,” but the insurer pays St. Joseph – and all other Rhode Island hospitals – at the level set by the federal government.
