State officials are urging Vermont’s biggest health care provider, University of Vermont Health Network, and the nation’s largest health insurer, UnitedHealthcare, to resolve their contract dispute.
“We have engaged with the executives at UVM Health Network and United Healthcare,” said Kevin Gaffney, commissioner of financial regulation. “We are listening and hearing and urging.”
The insurer and the health network announced Tuesday that they have been unable to agree to a contract and that as a result, more than 2,600 people insured by UnitedHealthcare would no longer be able to get in-network coverage at UVM Health Network.
Gaffney said he and Secretary of Human Services Jenney Samuelson are working on a joint statement urging the health network and the insurer to settle their differences.
When the two organizations were unable to reach agreement on a new contract last year, they extended their existing contract until they could sign a new one.
The contract dispute involves commercial contracts for health insurance bought by employers or by individuals. Gaffney said his department has some limited jurisdiction under the federal No Surprises Act, such as ensuring continuing care for pregnant patients and patients with cancer as well as emergency care.
“I’m hearing from both parties they’re aware of their responsibility under the No Surprises Act,” Gaffney said.
Medicare, Medicaid and veterans health care contracts are not affected by the dispute.
Gaffney estimated that fewer than 2,000 Vermonters are affected. In all, UVM Health Network and UnitedHealthcare have said that more than 2,600 people are affected, but that includes patients at UVM Health Network’s three New York hospitals.
“We are very concerned about this situation and, in particular, the patients who are stuck in the middle,” Owen Foster, chair of the Green Mountain Care Board, said in a statement emailed to VTDigger. “We encourage both parties to go back to the negotiating table to ensure that the impacted Vermonters have in-network access to their local health care providers.”
In September, the Green Mountain Care Board approved insurance rate increases of 14.77% for UVM Medical Center, 12.5% for Central Vermont Medical Center and 11.5% for Porter Medical Center, the three Vermont hospitals in the UVM Health Network.
UnitedHealthcare said Tuesday that UVM Health Network asked for more than a 15% increase, which would be above the amount allowed by the Green Mountain Care Board. UVM Health Network said UnitedHealthcare’s last offer was to raise reimbursement by a percentage in low single digits.