Rick May, president of the Colorado Medical Society, says the contract dispute between hospital operator HCA Inc. and insurance provider United Healthcare “needs a referee” to be resolved.
To that end, May sent a letter this month to David Rivera, the state’s commissioner of insurance, urging him to intervene.
“We need you to blow a whistle, throw a flag and throw a fit,” May wrote in the letter, dated Aug. 18.
Rivera said his hands are tied because state statute “prohibits me from getting involved in the contract negotiations between carriers and providers,” Rivera responded in a letter to May dated Tuesday.
According to May, that’s not good for Colorado residents.
Thousands of state residents might need to pick a new hospital or physician if a contract dispute between United and HCA can’t be resolved by the Friday deadline.
If a deal can’t be reached, HCA facilities would be considered “out of network” for United members. That means United members, depending on their plan, would have to pay as much as 100 percent of the bill for treatment at HCA facilities.
Treatment for emergency services would not be affected if the contract isn’t extended, Rivera said.
HCA, based in Nashville, Tenn., operates in Denver under the name HealthOne. Its facilities, which include Presbyterian/St. Luke’s Medical Center and Rose Medical Center, served nearly 1 million patients in 2005.
United, the state’s largest insurance provider, has 850,000 members statewide. Company officials updated those potentially affected by sending out 30,000 letters to those insured by United who used HCA facilities in the past year.
The two sides held meetings last week in Minneapolis, where United is based. Additional negotiations – largely focused on proposed reimbursement-rate increases – are scheduled for this week, said Linda Kanamine, a spokeswoman for HCA.
“We are still far apart,” Kanamine said of the negotiations.
May said patients statewide would be at risk if the dispute is not resolved. He said people insured through United would be forced to seek care at other hospitals, potentially overloading those facilities.
“Patients will face longer waits with more hassles,” reads May’s letter.
In addition, physicians working at unfamiliar hospitals – and with new support staffs – could “put patients at risk.”
Rivera said the insurance division has reviewed United’s so-called “access plan,” which intends to ensure adequate patient care if a contract extension can’t be reached.
“We are comfortable with the plan United has put forward,” he said.
Staff writer Will Shanley can be reached at 303-954-1260 or wshanley@denverpost.com.
