Fort Myers, Fla.-based Lee Health may end its in-network contract with WellCare Health Plans, a Tampa, Fla.-based Medicaid managed care provider, in 2019, The News-Press reports.
Lee Health and WellCare have partnered for two decades; however, the two organizations have been in court since 2015 over disagreements concerning emergency department payments. Mary Briggs, spokesperson for Lee Health, told The News-Press the payer allegedly issued "systematic underpayments" for ED services.
"Lee Health hoped to avoid sending a notice of termination to WellCare," Ms. Briggs said. "We still believe that termination of the contract is a last resort, and welcome the opportunity to resolve the issue and avoid termination."
WellCare COO Lee Bowers told The News-Press the payer is continuing discussions with Lee Health and is hopeful an updated contract will be inked shortly. "However, if we are unable to come to a resolution by August 2018, we have a comprehensive process in place to transition our members to alternative providers," he added.
Roughly 2,500 WellCare members received care at Lee Health hospitals in recent years, the report states.