About 20,000 patients could be left out of network if UnitedHealthcare and Syracuse, N.Y.-based SUNY Upstate University Hospital are unable to reach a new contract before the current one expires Dec. 31, syracuse.com reported Nov. 3.
UnitedHealthcare said the dispute affects its beneficiaries with the following plans:
- Medicare Advantage
- UnitedHealthcare Community Plan (Medicaid), including the Dual Special Needs Plan
- Employer-sponsored and individual plans
- Veteran Affairs Community Care Network
UnitedHealthcare said that Upstate is seeking a significant price increase that would make it one of the most expensive hospitals in New York for its Medicare Advantage plan, according to the report. The payer also said Upstate is seeking a 25 percent price increase over the next three years for employer-sponsored and individual plans.
Upstate said the cost of healthcare and demand for experienced staff have risen nationwide, according to the report. It said it has increased pay for employees and managed rising supply costs while dealing with the financial challenges of the pandemic.
UnitedHealthcare said the sides have agreed to a "cooling-off period" for beneficiaries enrolled in community plans and fully insured commercial plans, allowing them to have in-network coverage through Feb. 28, 2023 while contract negotiations continue.
The payer said the dispute does not affect its contract with Upstate University Medical Associates at Syracuse, the medical faculty practice affiliated with the hospital.