United Healthcare and Carson Tahoe at risk of contract termination

According to an article from the Record Courier on March 7, United Healthcare and Carson Tahoe Health may terminate their network contract due to ongoing payment issues. A contract termination would affect United Healthcare Insurance Co., and its affiliates, Northern Nevada Health Network, Inc. and Optum.

United Healthcare and Carson Tahoe contract negotiations

Carson Tahoe is a locally owned not-for-profit healthcare system that has been serving the community since 1949. They are affiliated with the University of Utah and their footprint includes two hospitals, two urgent care centers, outpatient services and a provider network with 21 regional locations. 

Impacted Carson Tahoe patients who use United Healthcare were notified of the possible network termination through a notice from Carson Tahoe Chief Executive Officer, Michelle Joy. The notice states that Carson Tahoe has given intent to terminate its contract with United due to “a significant number of claims for services already provided remain unpaid or underpaid.” 

This dispute between United Healthcare and Carson Tahoe is one of many like it. Disputes like these are not uncommon between healthcare systems and insurance companies. 

Last March, Aetna and Carson Tahoe were in a similar clash over contract negotiations, but came to an agreement in late April. Anthem and Northern Nevada Health System were in conflict in 2022 over network pricing at its two hospitals, Northern Nevada Medical Center and Northern Nevada Sierra Medical Center. In 2021, Prominence Health and Saint Mary’s Health Network began a multi-year dispute that resulted in terminated contracts and discontinued network access to Prominence HMO and Medicare members. 

There are many other examples of disagreements between health systems and insurance companies in our region in recent years. 

“While we are doing everything in our power to avoid any potential disruptions, if a resolution is not soon reached with United, you may no longer be covered by United for healthcare services at Carson Tahoe Health,” the letter states. “In the event Carson Tahoe Health is unable to reach an agreement with United and our contracts with United are terminated, it will be necessary for you to find a healthcare provider within the United network to maintain your coverage.” 

Members of United Healthcare and Carson Tahoe Health impacted by this dispute include those on an employer-sponsored group health plan or a United Medicare Advantage plan. Anyone on a Medicare Supplement plan from AARP/United is not impacted since there are no provider network restrictions on these types of policies. Medicare Supplement (or Medigap plan) beneficiaries can receive care from any doctor or facility that accepts Original Medicare, regardless of their insurance provider.

If you are a small business owner who has insurance through United and would like to explore alternative coverage options our team can help! Contact our Health Benefits Associates team at 775-362-3300 or stop by our office in South Carson located at 939 Mica Dr., Ste. 19A.