UnitedHealthcare hits back at Prisma Health lawsuit

UnitedHealthcare says it did not breach its contract with Greenville, S.C.-based Prisma Health, and said the health system "coordinated a media effort to put pressure" on the insurance giant. 

Prisma Health alleged UnitedHealthcare breached its contract by disclosing information about Prisma Health's rate proposals to several media outlets and not providing a copy of any statement to the media to Prisma 48 hours before publication. The health system requested a temporary injunction preventing UnitedHealthcare from disclosing further information. 

On Aug. 31, pending a final ruling, a judge granted Prisma Health's request to prevent UnitedHealthcare from disclosing additional information. According to the order, both parties agreed to seal certain documents filed in the case. The case is ongoing. 

In a response filed in South Carolina's 13th district court Aug. 29, UnitedHealthcare said Prisma Health "started this whole mess through its own media efforts." 

The two parties are in the midst of negotiating a new contract. 

According to the court documents, Prisma Health sent an email to its patients with UnitedHealthcare on Aug. 16, informing them the two parties would go out of network if they did not reach a new contract agreement by Jan. 1, 2024. 

Media outlets received copies of the email from multiple UnitedHealthcare customers,  UnitedHealthcare alleged in its response. 

"Prisma tried to use publicity and media pressure to gain an advantage in contract negotiations. United issued a statement responding to Prisma's efforts on that score and did so only after a reporter reached out about Prisma's own communications," UnitedHealthcare wrote in its response. 

In a response filed Aug. 30, Prisma Health said the email it sent was a confidential communication for Prisma Health patients who received benefits through UnitedHealthcare only. 

"The confidential communications sent to United members were sent only to patients of Prisma Health who, according to Prisma Health's records, receive their insurance coverage through a United plan. Prisma Health did not share the contents of the confidential communications with any member of the media," Malcolm Isley, chief strategy officer of Prisma Health, wrote in an affidavit filed with the court. 

Prisma Health alleged UnitedHealthcare violated its contract by disclosing the health system's proposed rate increases, which the system alleged was confidential. In its response, UnitedHealthcare said its statements to the press did not "disclose proprietary business information." 

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