Sarasota Memorial and UnitedHealthcare express optimism on new Medicare Advantage contract

Earle Kimel, Sarasota Herald-Tribune
·3 min read
Sarasota Memorial Health Care System and United Healthcare are making progress in talks on a new contract to keep SMH and First Physicians Group in network under the insurance company's Medicare Advantage plan.
Sarasota Memorial Health Care System and United Healthcare are making progress in talks on a new contract to keep SMH and First Physicians Group in network under the insurance company's Medicare Advantage plan.

Representatives of both UnitedHealthcare and Sarasota Memorial Health Care System said Tuesday that they are working on a deal to keep SMH and First Physicians Group in-network on UHC’s Medicare Advantage Plans. 

The current contract, which would impact roughly 20,000 retirees, is set to expire on Dec. 31, 2023.

“We are engaged in active, good-faith negotiation and continue to make progress toward our goal of reaching a new agreement that ensures continued, uninterrupted access to Sarasota Memorial Healthcare System,” UnitedHealthcare spokesman Cole Manbeck said via email. “We will remain at the negotiating table as long as it takes to renew our relationship.”

That resolve to come to terms was mirrored in an email response from SMH spokeswoman Kim Savage, who noted that, “In recent days, Sarasota Memorial and First Physicians Group have made significant progress in our contract negotiations with UnitedHealthcare.

“We’re optimistic that we will have an agreement in place by the end of the year,” she added. “We continue to engage in active, productive discussions with United, and we’re prepared to work around the clock and throughout the holidays to put an agreement in place."

Those statements came in response to a query from the Herald-Tribune after a retiree who depends on UnitedHealthcare’s Group Retiree PPO plan through her former employer messaged a reporter that she had been informed that the contract would end Dec. 31, 2023.

A case of mixed messages?

The woman, who did not want to be identified, told the Herald-Tribune that she contacted UHC by filing a Medicare service grievance through her UnitedHealthcare web account. She received an electronic response signed by a “Tiara G.” that said SMH would be out-of-network as of Jan. 1, 2024.

She subsequently reached out to the plan administrator of her former employer and was reassured there that UHC officials were working toward a contract resolution.

The conflicting messages may be a result of how the woman approached UHC.

Thirty days prior to the end of insurance contracts, companies typically send letters to their clients about the contract status, as well as steps to take should a provider become out-of-network.

That letter also includes a phone number to call for more information.

Email or electronic communications are not part of that information pipeline, Manbeck said.

The decision to file a “grievance” urging that the two sides come to an agreement likely led to the inaccurate response.

Manbeck said via email that UnitedHealthcare is looking into that incident.

The best place to receive updates from the insurance company’s perspective is https://www.uhc.com/sarasota though that site – last modified Nov. 30 – is being updated Manbeck said.

The SMH site, which was last updated Dec. 14, can be found at https://www.smh.com/unitedhealthcare.

What’s next?

The deadline for a resolution is Dec.31, though a contract could be approved prior to that.

It is also possible that if negotiations are very close, the two sides could choose to extend the existing contract, to allow for more negotiating time.

Sarasota Memorial and FloridaBlue did just that in 2021, while negotiating a three-year healthcare coverage contract.

This article originally appeared on Sarasota Herald-Tribune: SMH and UnitedHealthcare optimistic of Medicare Advantage pact renewal