Houston Methodist, major insurance company strike out on deal

HOUSTON, Texas (KTRK) -- Negotiations have failed between UnitedHealthcare and Houston Methodist, meaning patients with that medical insurance could receive a very large bill for care from Houston Methodist doctors or hospitals.

Both parties were unable to reach an agreement by New Year's Day, which was the deadline.

That means if you're treated at Methodist, you'll be charged out-of-network rates.

UnitedHealthcare and Methodist have been trying to come to a deal, but were at odds over contract renewals.

"If you're insured under United and you seek treatment in a Methodist hospital after January 1, 2020, they will not pay for you except at out-of-network rates, which means you could get a very large balance bill," Seth Chandler, a professor with the University of Houston Law Center, told ABC13 in October.

The companies had been going back and forth publicly and sharing their sides of the situation, with both stating that they were working in the best interest of the patient.

Houston Methodist claimed UnitedHealthcare reduced previously negotiated rates for how much they charge for care.

As for UnitedHealthcare, it claimed Houston Methodist charged too much for services.

Both sides sent statements to ABC13 about the failed negotiations on New Year's Day.

Houston Methodist statement

Houston Methodist had a contract in place with United for 21 years before they abruptly gave notice of termination a few months ago, creating confusion among our 100,000 patients insured by United. Although Houston Methodist negotiated in earnest, an agreement was not reached by the Jan. 1, 2020 deadline and now those Medicare Advantage and commercial patients must search for new doctors and new facilities.

It's obvious that UnitedHealthcare is more concerned with its bottom line than with thousands of patients having access to the No. 1 hospital in Texas.

We could not accept the insurance company's proposed cuts and compromise the high quality care we provide our community. During the negotiation, United continued to demand significant cuts to rates that it previously negotiated with us.

We are disappointed by United's actions-but not surprised given its aggressive actions against providers across the country. United's unfortunate decision - and disruption to their members' in-network access to Houston Methodist -- is forcing employers and consumers to pick different health care options for this year. Every step of the way, this has been about the patients for us, and the money for United.

As of today, patients with United insurance are encouraged to use our facilities and doctors if they have out-of-network benefits, and they are always welcome to seek emergency care in our hospitals or stand-alone emergency room centers. Patients undergoing treatment right now should call United about continuing their services.

We do not expect a significant change in our operations as there is a high demand for our services in Houston. We just wish United's patients could still have the choice to pick us for their medical care.

UnitedHealthcare statement

"Care at Houston Methodist Hospital is significantly more expensive than care at other top-ranked hospitals in Texas as well as some of the most prestigious hospitals in the entire country. Every time we attempted to reach a compromise during the negotiations, Methodist responded with proposals showing that it is intent on maintaining its position as one of the most expensive health systems in the country.

It's unfortunate that Methodist has been unwilling to actively participate in meaningful negotiations or to acknowledge that it's driving up the cost of health care for the people of Houston and the health care system overall. Instead, Methodist has chosen to spend its time and money blanketing the airwaves with ads and erecting billboards.

Our members can rest assured that they will continue to have access to high-quality, affordable care from the more than 90 hospitals and thousands of primary care physicians and specialists who are part of our Houston-area network. Our top priority is supporting our members as they transition to new care providers and ensuring they have uninterrupted access to the care they need."

United says it is open to continued conversations with Methodist. It also recommends patients undergoing treatment now should call United about continuing their services. The healthcare provider says those patients may be able to receive in-network rates for a limited time in the future.

ORIGINAL STORY: Methodist and United Healthcare's dispute could cost you money
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A public war of words has ensued between the two entities. The dispute could impact you.

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