Maryland patients face uncertainty as Johns Hopkins, UnitedHealthcare clash over insurance coverage terms
Negotiations between the two organizations have been going on for several months. While they have agreed on physician payment rates, the dispute centers on how medical care is approved and reimbursed.
In a statement, Johns Hopkins said it rejected what it described as "harmful" practices by UnitedHealthcare, including "aggressive claim denials that delay necessary care, excessive red tape that forces patients to wait for treatments, and significant payment delays that strain our ability to provide care."
UnitedHealthcare responded, saying that Johns Hopkins is seeking contract terms that would negatively affect employers and patients.
"We've reached agreement on financial terms and offered continued support to help Johns Hopkins more effectively manage the operational aspects of our relationship," said Joseph Ochipinti, UnitedHealthcare CEO for the Mid-Atlantic region. "However, Johns Hopkins is requiring contractual provisions that would negatively impact members and employers, allowing them to turn patients away at their discretion."
The contract dispute affects Johns Hopkins providers in Maryland, Virginia and Washington, D.C. UnitedHealthcare said Hopkins locations in Florida will remain in-network regardless of the outcome.
If no agreement is reached, Johns Hopkins hospitals will be out of network starting August 25 for patients enrolled in the following UnitedHealthcare plans:
In addition, Johns Hopkins physicians will be out of network for employer-sponsored commercial plans beginning on August 25. Hopkins physicians do not currently participate in UnitedHealthcare's Medicare Advantage or Medicaid networks.
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