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UnitedHealthcare, Wellstar reach deadline on contract disagreement leaving thousands without in-network coverage

Here are some of the changes.

ATLANTA — A contract has lapsed amid a dispute between UnitedHealthcare and Wellstar Health System, leaving thousands without their in-network care coverage Sunday.

Last week, Wellstar Health System said patients insured with UHC, received a letter in the mail, that stated "Wellstar is a not-for-profit organization" while "UnitedHealthcare is choosing profits over patients." 

On Sunday, Wellstar Health System released another statement on its website that stated its primary commercial contract with UnitedHealthcare has lapsed as of Oct. 3, while Wellstar Medicare Advantage Contracts with UHC have been extended through Dec. 31. 

"As of October 3, 2021, UnitedHealthcare is telling its commercial members they no longer have access to in-network benefits from Wellstar hospitals and physicians," according to Wellstar's website. "While it is accurate that UnitedHealthcare allowed its primary commercial network contract with Wellstar to lapse on October 3, 2021, UnitedHealthcare does continue to have in-network access to Wellstar physicians and hospitals through a secondary commercial contract UnitedHealthcare has with MultiPlan."

RELATED: UnitedHealthcare, Wellstar contract disagreement could leave 80,000 people at risk of losing in-network coverage

Wellstar Health System said until a new primary commercial contract can be negotiated, Wellstar "has given UnitedHealthcare consent to access Wellstar physicians and hospitals through our agreement with MultiPlan."

This offers a reimbursement rate that is a "substantial discount" from Wellstar's out-of-network charges. 

Wellstar said the new changes mean UnitedHealthcare is still able to access contracted rates for Wellstar physicians and hospitals for patients and their families if it chooses to do so. 

"At Wellstar, our patients are at the center of everything we do. For several years, Wellstar has been working to renegotiate a contract with UnitedHealthcare that would result in reimbursements for Wellstar hospital and physician services similar to those from other health insurance providers," Wellstar's website stated. "We understand how important it is to have full access to the local, high-quality providers and hospitals you know and trust, and we continue to work on reaching a new primary commercial agreement that prioritizes patient care."

Additionally, UnitedHealthcare released the following statement Sunday: 

"Wellstar’s hospitals are already the most expensive in Atlanta, yet Wellstar refused to move off its demands for an egregious 37% price hike over three years that would have increased health care costs by more than $109 million. This is not sustainable or affordable for the people and employers we serve. While it’s unfortunate Wellstar terminated the contract we just renewed in the summer of 2020, our top priority at this time is ensuring our members have access to the care they need and supporting them as they transition to one of the more than 30 hospitals and approximately 12,000 physicians that participate in our network in Atlanta and the surrounding communities."

Click here to read more on the changes and how this impacts different healthcare plans. 


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