After months of negotiations, LVHN said UnitedHealthcare has not engaged fairly and failed to honor previously agreed-upon rates. UnitedHealthcare said LVHN issued notice to end the contract and is demanding a price hike of more than 20% in a single year. Both organizations shared updates on January 21.

At this point, this only affects Medicare Advantage members. However, commercial members should monitor closely as that contract expires on April 25 — and the failure of this contract does not bode well for that one.

I will continue to monitor.

Source: Becker’s Payer Issues

Lehigh Valley Health Network (LVHN) and UnitedHealthcare are running out of time to work out their differences.

LVHN announced last fall that it would terminate its contract with the insurance giant this month unless the two could reach an agreement on the terms moving forward. January 26 was the day given that Medicare Advantage patients covered by UnitedHealthcare would no longer be able to receive in-network care with LVHN providers; commercial contracts would end beginning April 26.

It doesn’t seem like much has changed since the impasse was first made public.

LVHN, which is part of Jefferson Health, maintains that, since 2021, UnitedHealthcare has reduced its reimbursements by nearly 40 percent without agreement. The insurance company flat out denies that, and claims LVHN is the problem because it’s demanding a more than 20 percent price hike in the first year of the contract.

Source: WFMZ 69 News

Lehigh Valley Health Network said Monday it is planning to drop UnitedHealthcare insurance plans, a move that could lead to higher out-of-pocket costs for approximately 70,000 patients starting next year.

If new agreements aren’t reached, contracts will end January 25, 2026, for patients who have Medicare Advantage plans through UnitedHealthcare, and April 25, 2026, for patients with commercial insurance policies.

The move only affects patients seeking care at legacy LVHN hospitals and doctor offices. Jefferson Health has separate contracts with UnitedHealthcare that will remain in effect.

Source: Morning Call