LOUISVILLE, KY – Facing ongoing concerns about delays in patient care and coverage denials for care that has already been provided, UofL Health has issued a termination notice for the United Healthcare Medicare Advantage plan. Coverage for patients on that plan will be considered “out-of-network” for hospital and medical center services starting May 1, 2025.
“This has not been an easy decision, but United Healthcare is simply not delivering on promises made to its Medicare Advantage patients or providers,” said Tom Miller, UofL Health CEO. “We will not turn away any patient in need of care, but United Healthcare has created an unmanageable process that creates too many administrative hurdles when sick people just need care and the confidence they are covered.”
Notices are being sent to approximately 12,000 impacted patients to inform them of the change for hospital and medical center services. If a patient chooses to seek care elsewhere, UofL Health will work to ensure continuity of care, transferring all records and information as appropriate. UofL Physicians office visits are covered under a separate agreement and will continue to be covered as “in-network” at this time.
Claim validation is an important part of insurance payment integrity, but the burdensome process created by United Healthcare Medicare Advantage is unnecessary and negatively impacts care. One out of every four of our patients on the United Healthcare Medical Advantage plan have been denied coverage for care already provided. This puts undue stress on patients trying to heal and puts an unsustainable financial strain on health systems.
“I am concerned about barriers put up for those that really need care,” said Dr. Jason Smith, UofL Health chief medical officer. “We care deeply about our patients and the care they receive, which is why we are unwilling to continue with the status quo. Denials of care and onerous per-approval processes put our patients, physicians and other providers in an untenable position.”
UofL Health continues to accept traditional Medicare, operated by the Federal government, and other Medicare Advantage plans from other insurance companies.
