Denville, New Jersey.
Prime Healthcare’s New Jersey hospitals announced its decision to terminate its contracts with UnitedHealthcare, citing that they are being significantly underpaid compared to the rates of neighboring facilities. The decision to terminate its contracts with United specifically impacts Saint Clare’s Health in Denville, Dover and Boonton, Saint Michael’s Medical Center in Newark, and Saint Mary’s General Hospital in Passaic.
According to Sonia Mehta, MD, Regional CEO & Chief Medical Officer of Prime Healthcare New Jersey, “We have been significantly underpaid for years by UnitedHealthcare, including some rates well below Medicaid. United’s contract proposal is not reasonable and jeopardizes our ability to continue to deliver the quality care that our patients deserve.” Due to new disclosure requirements by CMS, all hospitals must now disclose their contracted rates and Prime Healthcare learned that it had been significantly underpaid compared to what United has been paying neighboring hospitals.
The New Jersey Hospital Association (NJHA) has reported that Prime Healthcare hospitals provide quality healthcare services and that its cost of care is among the lowest in the State of New Jersey. Prime Healthcare New Jersey hospitals include Saint Clare’s Health in Denville, Dover, and Boonton, St. Mary’s General Hospital in Passaic, and Saint Michaels Medical Center in Newark.
“We are patient-focused and are committed to delivering the most compassionate care by exceptional physicians using state-of-the-art technology. Undercutting our payments is unacceptable, and so we are taking the necessary step of providing notice of our intent to provide care out-of-network. We realize it is a bold move, but a necessary one to separate our hospitals from organizations that work contrary to our mission and commitment to our patients,” stated Mehta.
The Prime Healthcare New Jersey hospitals will continue to honor the rates and services in the agreements until the end of the cooling off period, which is December 16, 2021 for the Medicaid product and December 31, 2021 for the commercial and Medicare products. Of course, all patients can continue to rely on the Prime Healthcare New Jersey hospitals for emergency services, regardless of insurance, and the hospitals are willing to negotiate single patient agreements for elective services. The hospitals will also honor all continuity of care services for United members.