Stalemate between NGHS, UnitedHealthcare may soon affect Habersham Medical [The Times, Gainesville, Ga.]

Times, The (Gainesville, GA)

Jun. 5—With no contract resolution in sight, Northeast Georgia Health System and UnitedHealthcare can't even agree on the status of Habersham Medical Center when it joins NGHS on July 1.

UHC "knows that on July 1, when Habersham Medical Center joins NGHS, it will become a new corporation — NGMC Habersham — that is not contracted with United, meaning all services provided at this location will be out of network," said Steve McNeilly, NGHS' vice president of managed care operations.

"This is not true," UHC spokesman Cole Manbeck said in a recent email. "UnitedHealthcare has a separate direct agreement with Habersham Medical Center for the services it provides. The contractual terms and requirements will apply on July 1 and beyond.

Accordingly, our agreement with Habersham is not impacted by the NGHS termination and they will remain in-network."

NGHS officials announced in January that financially struggling Habersham Medical Center in Demorest would join the health system a year earlier than expected.

Some of Habersham Medical Center's top executives were dismissed in April in an effort to cut costs before the takeover, or about the same time talks were starting to break down between NGHS and UHC.

"We provided a fair and reasonable proposal on March 31 that included meaningful rate increases," UHC said in a May 15 statement. "Unfortunately, NGHS refused to respond to our proposal, canceled all of our meetings over the past few weeks and chose to disrupt Georgians' access to its hospitals and physicians."

According to NGHS, "The last communication we had about the contract with United was on April 17 when we reached out to their senior leadership in Georgia to encourage them to accept our latest proposal. Unfortunately, United did not respond, and they have not been in touch with us since then."

McNeilly did say on Monday, June 5, that United and NGHS "are in active discussions regarding the participation of NGHS entities after" June 30.

A contract between the two sides expired April 30 without an extension agreement.

NGHS has noted on its website that United had "removed all NGHS locations from its network for patients with commercial health insurance plans.

The negotiations primarily affect those on employer-sponsored or individual health plans, or, according to UHC, more than 12,000 policyholders.

NGHS has "refused to move off its demands for a more than 20% price hike over the next three years, including a double-digit rate increase in the first year that would make its hospitals the most expensive in Georgia," UHC has said.

The hospital system said on May 1 it "is actually only asking for a single-digit increase to bring UnitedHealthcare in line with other commercial insurance companies" and "the proposal they sent on March 31 is unreasonable. They know we cannot accept it."

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