UNC Health dispute with large insurer could impact coverage for 200,000 patients [The News & Observer (Raleigh)]

News & Observer (Raleigh, NC)

A contract dispute between UNC Health and UnitedHealthcare — one of the largest health insurers in the United States — could affect the insurance coverage of hundreds of thousands of patients.

If the two companies do not reach an agreement, a lapsed contract would make UNC Health out-of-network for about 200,000 of its patients starting April 1, the health system informed its patients this week in a letter.

Those patients would need to change insurance providers or change physicians in order to avoid higher out-of-pocket costs for UNC Health services.

The negotiation disputes center around UnitedHealthcare’s reimbursement rates, which UNC Health claims are too low to compensate for rising labor costs and inflated supply expenses.

The health system also wants assurances in the contract that the insurance company will reduce delays and claim denials.

Cole Manbeck, a spokesperson for UnitedHealthcare, said the insurance company intends to negotiate in good faith for the next six months to come to an agreement.

He called UNC’s letters to patients a negotiation tactic that creates “unnecessary fear and stress.”

This dispute comes nearly a year after WakeMed settled its dispute with UnitedHealthcare.

The contract between the two companies lapsed in June 2022 due to conflicts over reimbursement policies, rate increases and insurance claim errors. After months of failed negotiations that affected thousands of patients, the two companies signed a three-year contract in November 2022.

Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.