Fairview sues UnitedHealthcare over 2027 Medicare plan info

Fairview Health Services is suing UnitedHealthcare, saying the nation’s largest insurer is wrongly telling seniors the health system’s hospitals and clinics will be part of its Medicare Advantage network for 2027.

Minneapolis-based Fairview has asked a federal judge to issue a temporary restraining order to stop the insurer from including the health system’s facilities and physicians in the Medicare Advantage network guides.

Fairview also wants an order requiring UnitedHealthcare to surrender profits earned from Fairview patients enrolling in its 2027 plans, plus a permanent injunction to stop the alleged misrepresentations.

The dispute over whether UnitedHealthcare should be able to advertise a network that includes Fairview health care providers adds to an already confusing season for many Minnesota Medicare shoppers.

More than 320,000 Minnesotans must find replacement coverage for Medicare Advantage plans discontinued next year.

Based in Minnetonka, UnitedHealthcare is the largest provider of Medicare Advantage plans, which are privatized versions of the federal government’s health insurance program for seniors and younger people with specific conditions.

Fairview told patients in June that it would leave UnitedHealthcare’s Medicare Advantage network and stop scheduling and seeing patients in those plans for non-emergency visits beginning Jan. 1.

Yet UnitedHealthcare’s online directories for 2027 listed Fairview as an in-network provider as of Oct. 1, according to the lawsuit filed this month in federal court in Minnesota.

Fairview is seeking a court order to stop the alleged misrepresentations before Medicare enrollment begins Oct. 15. U.S. District Judge Katherine Menendez scheduled an Oct. 13 hearing on its request for a preliminary injunction.

Corrections are needed, Fairview argues, because seniors might otherwise select UnitedHealthcare coverage believing they could continue receiving non-emergency care under those plans at the health system.

Fairview runs hospitals and clinics including University of Minnesota Medical Center in Minneapolis. The nonprofit is one of the state’s largest health systems.

The health system says about 33,000 current patients are enrolled in UnitedHealthcare’s Advantage plans.

“We gave UnitedHealthcare clear notice months ago that Fairview will not participate in its Medicare Advantage plans in 2027,” Dr. Jaya Kumar, chief medical officer of Fairview Health Services, said in a statement. “If patients are told otherwise when they choose their coverage, they could make a decision they cannot easily undo.”

In a statement, UnitedHealthcare cited its ongoing effort to reach an “affordable” contract that secures long-term access to Fairview. If the two sides cannot agree, the insurer said it would follow federal guidelines and notify members that Fairview could leave its network.

Fairview says there are no negotiations.

The health system acknowledged UnitedHealthcare had repeatedly approached it about a new contract, but said it had consistently rejected those overtures, according to a Sept. 28 letter that is part of the court filing.

The health system’s lawsuit asserts Fairview will not “under any circumstances” contract with UnitedHealthcare (UHC) Medicare Advantage plans for 2027.

“Without judicial intervention to stop UHC’s misrepresentations, Medicare patients will be left to decide for themselves whether their provider, Fairview, or their insurance company, UHC, is telling the truth,” the health system said in its lawsuit. It claims seniors face “imminent harm.”

Concern over the accuracy of Medicare Advantage network directories arose in 2024, when the Minnesota Star Tribune reported UnitedHealthcare was listing HealthPartners facilities as in-network for 2025 despite the health system’s announced departure. The two sides ultimately reached an agreement for 2025 that preserved in-network access.

Rising medical costs and decreased federal funding have driven big Medicare Advantage changes the over the past two years, insurers say, including decisions to exit certain markets or stop offering specific plans.

Minnesota insurers say local market instability also stems from the financial meltdown at UCare, a large Medicare Advantage provider that went out of business at the end of 2025.

Fairview says it has renewed agreements for 2027 with several Medicare Advantage insurers, including Blue Cross Blue Shield of Minnesota and Medica. It is still negotiating with HealthPartners.

But Fairview says it won’t renew with UnitedHealthcare, which the health system says has repeatedly delayed reimbursements or paid Fairview less than it was owed — allegations United has previously denied.

The insurer requires burdensome approvals before patients can receive care, Fairview claims, while denying payment for medically necessary treatments that would have been covered by traditional Medicare. United also has disputed those accusations.

Fairview’s relationship with UnitedHealthcare has become “increasingly fraught” over the past five years, according to an Oct. 2 declaration by Melissa Lindberg, the health system’s vice president of revenue management, that was filed with the court.

Lindberg said she notified UnitedHealthcare in June that Fairview would not renew its contract. In September, she repeatedly sought confirmation it would be removed from the insurer’s directories for 2027.

On Oct. 1, when public advertising began for next year’s plans, Lindberg said she asked what the insurer had told patients about Fairview’s exit in an annual letter members receive about plan changes. UnitedHealth representatives said they needed to investigate, according to her declaration.

Despite the many communications, Lindberg’s declaration said UnitedHealthcare did include the health system on its lists of in-network Medicare Advantage providers for 2027.

“As a result, Fairview must contact patients to try to counteract the false information spread by UHC, which creates a significant cost and financial burden to Fairview,” she said. “Fairview is also at substantial risk of losing current patients who enroll or renew through UHC under the false impression that Fairview remains in-network in 2027.”

Screenshots dated Oct. 1 and filed with the lawsuit show the insurer identifying Fairview facilities as in-network for 2027.

UnitedHealthcare’s provider directories include warnings that networks can change and advise patients to confirm participation with their insurer and provider.

An annual coverage-change notice filed as a legal exhibit directs members to the insurer’s 2027 directory to check whether their doctors and hospitals remain in-network, without identifying Fairview’s departure.

Separately, Fairview says its agreement covering people who get UnitedHealthcare insurance through their employer plans is unaffected. Patients with those plans will retain in-network access in 2027.

The health system is providing information for patients at mhealthfairview.org/UHCupdate.

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