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.
More articles on payer issues:
CMS: Insurers applying to sell plans on ACA exchanges fall 38%
Cigna acquires Zurich Insurance Middle East
UnitedHealth’s OptumRx wins $2B New Jersey drug contract
