Minneapolis-based Fairview Health Services filed a lawsuit Oct. 1 against UnitedHealthcare, alleging false advertising with the insurer’s 2027 Medicare Advantage plans.
The complaint, filed in Minnesota federal court, said Fairview decided in June to not renew its contract with UnitedHealthcare’s MA plans for 2027. However, the lawsuit said UnitedHealthcare has falsely presented that Fairview would remain in network.
The court filing said Fairview is not in negotiations with the insurer and does not anticipate reopening them. According to the complaint, Fairview has faced challenges working with UnitedHealthcare MA plans over the years, such as with payment delays, low reimbursement, prior authorization and payment denials.
“Fairview did not agree that UHC could use Fairview’s name in advertising its MA plans for 2027 and expressly instructed UHC not to do so,” the complaint said.
The lawsuit alleged, in a September meeting with UnitedHealthcare, Fairview asked the insurer to confirm the health system would not be in provider directories for 2027, but UnitedHealthcare “reacted to this question with surprise and was not able to provide an answer.” The system followed up that same day, seeking formal written assurance. In the days that followed, Fairview’s legal department sent a written notice that the system would not contract with UnitedHealthcare for MA plans “under any circumstances” for 2027.
UnitedHealthcare’s annual notice of change directed enrollees to an online provider directory that allegedly still lists Fairview as in network for 2027, according to the lawsuit.
“Current UHC MA enrollees who are Fairview patients face substantial confusion because Fairview has informed them it will be out-of-network with UHC MA and UHC has now told them the opposite,” the lawsuit said.
Fairview is seeking several forms of relief, including a temporary restraining order leading up to annual enrollment Oct. 15, an order awarding the system profits that UnitedHealthcare earns from Fairview patients enrolling in an MA plan for 2027 and compensatory damages to cover Fairview’s costs with Medicare patient outreach. In an Oct. 7 news release shared with Becker’s, Fairview estimated that it has served about 33,000 UnitedHealthcare MA patients each year.
“We are asking the court to require accurate information before enrollment begins, when patients still have the opportunity to make an informed choice,” Fairview’s Chief Medical Officer Jaya Kumar, MD, said in the release.
“We continue to engage in good faith with Fairview Health in an effort to reach an agreement that is affordable, while maintaining long-term network access to the health system,” UnitedHealthcare told Becker’s. “Should we not reach an agreement, we will communicate to our members the possibility Fairview could go out of network, in accordance with CMS guidelines.”
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