Apr 10, 2018

UnitedHealthcare terminates Envision contract

An empty emergency room bed.

Envision Healthcare runs emergency rooms. Photo: ERproductions Ltd / Getty Images

UnitedHealthcare "has opted to terminate" its contract with Envision Healthcare and Envision's subsidiaries "no later than January 1, 2019," according to a new court filing. The health insurance giant also is asking the court to force Envision into arbitration to resolve their dispute.

Why you'll hear about this again: Next year, people with UnitedHealthcare coverage would be on the hook for a big chunk of their costs if they get care at an Envision facility or a hospital that uses Envision as a contractor. However, people usually don't know if their care is handled by an outside contractor until well after they get billed.

The details: UnitedHealthcare alleged in its court filing, in response to Envision's initial lawsuit, that Envision had "egregious billing practices" and "engaged in an improper game of hide-the-ball" to pad profits — particularly in emergency rooms that hospitals farmed out to Envision.

  • Envision's original complaint said UnitedHealthcare forced Envision's doctors "to contract with United on unreasonable terms or to be out-of-network." Envision spokesperson Kim Warth reiterated many of the same points from the lawsuit.
  • Regarding the contract termination, Warth said: "We hope to come to an agreement for 2019 and beyond that provides for fair and reasonable reimbursement for the care we provide to patients."
  • Envision has been in the hot seat for months now for its high out-of-network charges that have caught patients off guard.
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