United Healthcare on Monday filed a lawsuit against hospital operator HCA Inc., alleging the Denver area’s largest hospital system is using its dominant position to hike prices for insurers and disrupt patient care.
The 41-page suit, filed in U.S. District Court, stems from the ongoing contract impasse between Minneapolis-based United, the state’s largest insurer, and HCA, which operates seven metro-area hospitals under the HealthOne name.
Nashville, Tenn.-based HCA terminated its local contract with United on Sept. 1 over reimbursement rates for the cost of care. HCA’s facilities are now “out-of-network” for the 850,000 Colorado residents insured through United and its affiliates, PacifiCare and SecureHorizons.
Emergency services at HCA facilities, including Swedish Medical Center, Rose and Presbyterian/St. Luke’s, are still covered at in-network rates for United members.
“These terminations were the first steps in a deliberate and ongoing scheme to extract anti-competitive and unreasonable rates for medical services in the Denver metro area,” the lawsuit states.
HCA spokeswoman Linda Kanamine said the company will “oppose the lawsuit and the antitrust claims.”
“We can’t let this issue distract us from the (fact) that this insurance company won’t come to the table and agree on fair reimbursement rates,” she said.
Tyler Mason, a United spokesman, said the lawsuit is two- pronged.
First, United hopes to obtain a temporary restraining order that reinstates its on-site nurses. HCA had barred United’s nurses from its hospital facilities.
Kanamine said HCA has already allowed the nurses to return to HCA facilities, but added, “We aren’t going to let them disrupt patient care.”
The lawsuit also seeks to reverse what United contends is the wrongful termination of a contract that covered imaging services.
Mason said the contract covering imaging services was set to expire in November and is usually renewed separately from the deal that covers United and HCA’s other facilities.
United contends that HCA controls 70 percent of the women’s radiological imaging services in Denver, including mammographies.
“HCA has used its market power in Denver to attempt to extort anti-competitive rates for hospital-related services, ambulatory surgery services and imaging services,” the lawsuit states.
Mason said the imaging center contract was “put in play to put leverage on the contract” negotiations.
In response, Kanamine said: “We disagree with the claims they make in the lawsuit, and we will defend ourselves.”
Staff writer Will Shanley can be reached at 303-954-1260 or wshanley@denverpost.com
