Envision sues UnitedHealthcare over network policies in New Jersey

Morgan Haefner - Print  | 

Envision Healthcare filed a lawsuit May 28 against UnitedHealthcare, claiming its network contracts with New Jersey hospitals violate state policy.

The lawsuit claims that UnitedHealthcare has "an effective veto power over hospitals' staffing decisions for crucial services like emergency medicine and anesthesiology ... by requiring hospitals to contract with physicians who are also in-network with United."

In January, an agreement between UnitedHealthcare and Nashville, Tenn.-based physician staffing firm Envision Healthcare ended after the organizations couldn't agree on reimbursement rates. UnitedHealthcare said the change would affect physician groups in 44 states and the District of Columbia. Most of the affected physicians provide emergency room and anesthesiology services. Some Envision physicians also provide radiology, neonatology, hospitalist, primary care and specialty care services.

Envision said the move forced 25,000 clinicians out of UnitedHealthcare's provider network.

"Envision supports New Jersey's steps to protect patients through its Health Care Facilities Planning Act, which states that hospitals and related healthcare services should be high quality, efficient and reasonable in cost," Envision said in a statement. "However, we believe United is trying to dictate the delivery of care based on how it impacts its profits and its market position, rather than the level of care quality and expertise our clinicians provide." 

Becker's reached out to UnitedHealthcare for comment but didn't hear back by publication. This article will be updated if more information becomes available. 

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