Patients left in limbo as UnitedHealthcare, Johns Hopkins negotiate care plans
Patients left in limbo as UnitedHealthcare, John's Hopkins negotiate
The home of Maryland's largest children's hospital, Johns Hopkins University, may force patients to pay out of pocket if they can't reach a deal with United Healthcare. If Johns Hopkins and United Healthcare can't reach a deal, you will no longer be in-network at Hopkins facilities if you have United Healthcare's insurance.
WASHINGTON - The home of Maryland's largest children's hospital, Johns Hopkins University, may force patients to pay out-of-pocket if they can't reach a deal with United Healthcare.
If Johns Hopkins and United Healthcare can't reach a deal, you will no longer be in-network at Hopkins facilities if you have United Healthcare's insurance.
What we know:
Johns Hopkins provides care to residents in 19 different locations across the D.C. area.
Their facilities are widespread across our region and include major hospitals like Sibley and Suburban alongside specialists in neurosurgery, cardiology and colorectal surgery—all areas where it can take a long time to develop a relationship with your doctor.
What they're saying:
Johns Hopkins is accusing United of pushing harmful practices that would hurt patients, like aggressively denying claims that delay patient care and excessive red tape forcing patients to wait for treatment.
United says this isn't about money and that they've agreed to financial terms. They accuse Hopkins of including contract terms that would hurt employers. They also say those covered by United insurance will have other options in the DMV.
One expert says we're not getting the full picture from these statements that Johns Hopkins is fighting for the right to reject certain United plans that would be unfair to patients.
"The truth is that they're not wanting to refuse treatment to certain patients. They're wanting the right to refuse to work with certain healthcare plans under United that certain employers might choose because they've decided that certain plans engage in too much delay and deny," attorney Madeline Summerville, said. "This is Johns Hopkins' attempt to try to resolve that problem. You know we've heard about the delay and deny issue with the [United] Healthcare CEO, of course, and society's kind of accepted that that's an issue."
What's next:
United says that if you are in the middle of treatment for a serious or complex condition—if you have cancer or are pregnant, for example—you are eligible for continuity of care.
That means you can keep paying in-network prices until your treatment is done, but you have to apply for it and get approved as it is not automatic.