If a court doesn’t rule in its favor today, UnitedHealthcare said it will notify via mail those it insures in Colorado that HCA-HealthOne imaging and mammography services will be “out-of-network” starting in November, the company said Wednesday.
Since Sept. 1, HCA-HealthOne facilities have been out-of-network for United members, but the imaging and mammography services were to be covered through early November.
In a court hearing scheduled for today, United will ask a judge to issue a temporary restraining order preventing HCA from terminating the imaging and mammography contract.
The contract covering imaging services is usually renewed separately from the deal that covers United and HCA’s other facilities, said Tyler Mason, United spokesman.
United on Monday filed a lawsuit against HCA alleging that the hospital operator unfairly tied the separate contract for imaging and mammography services to broader negotiations with HealthOne over reimbursement rates.
The lawsuit also alleged that Health One has inappropriately barred United’s nurses advocates from its hospital facilities.
HealthOne had until noon Wednesday to file a response to United’s lawsuit in U.S. District Court in Denver.
HealthOne said in court documents that United’s pending lawsuit amounts to a public-relations move and is aimed at gaining leverage in the stalled negotiations – not protecting patients.
“United’s effort to secure a temporary restraining order against Health One is a blatant attempt to misuse the court’s powers,” HealthOne said in court documents. “United improperly seeks to use this court to accomplish business goals that are appropriately achieved at the negotiating table, not in the courtroom.”
United’s lawsuit also claims that Health One is using its dominant position in mammography and imaging services to hike up health-care costs.
“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,” United’s lawsuit states.
Linda Kanamine, a HealthOne spokeswoman, said HealthOne would “vigorously defend” itself against the antitrust claims.
Separately, the state division of insurance approved a credit by United to small- and mid-sized business owners who have lost access to HCA facilities. The credit amounts to a 7.5 percent discount on the businesses’ United insurance rates.
Minneapolis-based United, the state’s largest insurer, and Nashville, Tenn.-based HCA, which co-owns the metro area’s largest hospital system, have been locked in a months-long contract dispute over reimbursement rates.
HCA terminated its local contract with United on Sept. 1. That means 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.
Staff writer Will Shanley can be reached at 303-954-1260 or wshanley@denverpost.com.
