After months of negotiations, UNM Hospitals and UnitedHealthcare have been unable to agree on renewal of UnitedHealthcare’s Centennial Care provider agreements with UNM, and the existing contract between the two organizations will expire at the end of June 2016.
The contract termination means that UNM Hospitals will be out-of-network for UnitedHealthcare Centennial Care members. The termination of the Centennial agreement will not impact emergency room and trauma care or behavioral health care services, which will still be covered.
UnitedHealthcare members who have commercial insurance plans or are part of employer plans aren’t affected by the Centennial Care contract termination and UNM will still be “in-network” for these insurance plans.
“While we were unable to reach an agreement with UnitedHealthcare in this challenging financial environment, UNM remains committed to providing our patients with access to the best care and service,” says Michael Richards, MD, executive physician-in-chief for the UNM Health System. “We are doing everything we can to minimize any disruption for patients.”
Richards noted that as an academic medical center and the state's only level 1 trauma center, UNM sees the sickest patients and receives the most complicated medical cases in the state. Insurance reimbursement rates are designed to cover the costs of providing this complex care, he said.
"UnitedHealthcare notified us several months ago that it wanted to cancel its current contract with UNM and proposed a reduction in its reimbursement rate," he said. "This reduction, unfortunately, would not come close to covering the costs of providing care to its Centennial Care members.”
Beginning next month, UnitedHealthcare Centennial Care members will no longer be covered for elective services from UNM hospitals, clinics and physicians, including primary care doctor visits, specialist visits, and non-emergency surgeries and medical tests. The termination will affect about 2,000 patients.
UnitedHealthcare Centennial Care members who are scheduled for such a service at UNM after July 1, 2016, should contact their UNM provider to discuss options for continued care. UnitedHealthcare Centennial Care patients wanting to continue their services at UNM have the option to switch their coverage to a UNM-contracted managed care organization. Affected patients also can work with UnitedHealthcare to find another in-network provider. For more information, call the UNM Hospitals help line at 505-272-7878.