A contract dispute between UnitedHealthcare and a physicians' group that manages high-risk pregnancies has left thousands of parents unsure whether their medical care will be covered by insurance, reports AZ Central.
Obstetrix provides medical care to women who experience complicated pregnancies and newborns who face medical and developmental challenges. Obstetrix is owned by Mednax, a Sunrise, Fla.-based medical group with 3,240 providers across 35 states.
Below are three things to know about the dispute.
1. UnitedHealthcare terminated its contract with Obstetrix last July, affecting about 6,000 policy members who receive medical services from Obstetrix physicians.
2. The dispute centers on payment rates. UnitedHealthcare accused the physician group of charging as must as 465 percent of what Medicare pays for similar services. Obstetrix officials said its average charges are half the rates commercial insurers pay.
3. Continuity of care provisions allow for ongoing coverage for pregnant women who were being treated by Obstetrix providers prior to the contract termination last July. Obstetrix physicians are out-of-network for UnitedHealthcare members who became pregnant after July 1.
More articles on payer issues:
La. Medicaid program renamed 'Healthy Louisiana'
BCBS of Illinois will stop accepting credit card payments
5 trends in large employer-sponsored health benefits