UnitedHealthcare dumps Envision contract: 4 things to know

UnitedHealthcare opted to terminate its agreement with Nashville, Tenn.-based Envision Healthcare no later than Jan. 1, 2019, according to recent court documents.

Here are four things to know about the ongoing dispute.

1. In an April 6 court filing, UnitedHealthcare — the health insurance arm of UnitedHealth Group — said it's terminating its contract with Envision because the provider has been "unwilling to address matters with UHC in a reasonable and satisfactory manner — demonstrated most recently by the filing of this lawsuit in blatant disregard of the parties' valid and enforceable arbitration provision."

2. UnitedHealthcare argued Envision wrongfully sued the payer and by doing so broke an arbitration clause in their agreement. The insurer also called Envision's emergency room billing practices "egregious."

3. The termination notice is the latest in the feud between UnitedHealthcare and Envision. In late March, UnitedHealthcare created a website targeting Envision's ED billing policies. On March 14, Bloomberg reported UnitedHealth tossed its attempt to acquire Envision's ambulatory services unit, according to sources familiar with the matter. That news came as Envision sued UnitedHealth for allegedly lowering contracted payments to Envision physicians and not allowing new Envision medical practices to join its network.

4. In a statement to Becker's Hospital Review, Envision said, "From our perspective, these are two separate issues that United has chosen to combine to distract from the original breach of contract complaint. Regarding the litigation, as stated in our complaint, UnitedHealthcare is in breach of contract by failing to recognize Envision medical providers, unfairly adjusting rates it pays Envision and refusing to comply with the contract's process for handling disputes. This is the next step after multiple attempts to resolve the situation. We are asking the courts to hold United accountable for its contractual agreements and obligations under terms of the contract they signed.   

"Regarding the separate issue of future contracting with United Healthcare, as we publicly declared earlier this year, Envision Healthcare's goal is to be in-network with as many payors as possible … we hope to come to an agreement for 2019 and beyond that provides for fair and reasonable reimbursement for the care we provide to patients."

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