Fort Myers, Fla.-based Lee Health said it would terminate hospital and physician contracts with UnitedHealthcare at the end of 2026.
Beginning Jan. 1, 2027, Lee Health will be out of network for UnitedHealthcare employer-based, individual and Medicare Advantage plan members. Lee Health said UnitedHealthcare does not consider the health system to be part of the insurer’s exchange plans.
According to an open letter to patients from Lee Health, one of the health system’s main concerns is the effect of UnitedHealthcare’s authorization, review and denial processes on timely care access. Lee Health said roughly one-third of medical necessity denials are linked to UnitedHealthcare MA plans.
In the letter, Lee Health also alleged that UnitedHealthcare owes the system more than $100 million in disputed and underpaid claims.
“Ultimately, Lee Health and UnitedHealthcare have fundamentally different priorities. While Lee Health is guided by our nonprofit, community-focused mission and our decisions are guided by patient access, outcomes and community benefit, UnitedHealthcare is a for-profit company with obligations to its global shareholders,” the letter said. “We worked for years in good faith to address these concerns, and UnitedHealthcare was fully informed of them throughout that process.”
A UnitedHealthcare spokesperson said the alleged issues had not been previously raised with the insurer, and there were no contract negotiations taking place leading up to the announcement.
“Lee Health unexpectedly issued a notice to end our network relationship at the conclusion of our current contract without any advance notice or discussions,” the UnitedHealthcare spokesperson said. “We believe that productive conversations, rather than public threats that leverage patients, are in the best interest of the communities we serve. While we are disappointed by Lee Health’s tactics, we remain committed to using the more than four months remaining on our contract to engage in good-faith negotiation and reach a long-term agreement that provides continued access to Lee Health at an affordable cost for families and employers.”
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