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With end of United-BayCare contract, what's next for patients?

Nearly a half-million UnitedHealthcare customers in the Tampa Bay area now have only limited access to the region's largest hospital system.

The contract between United and BayCare Health System expired Monday after a bruising public battle over rate increases. Though insurers and providers often have contract disputes, it's rare that they aren't sorted out in negotiations. Still, experts say the United-BayCare fight could be a sign of the times, as escalating health care costs prompt insurers and employers to take a harder line.

Whether they have commercial, Medicaid or Medicare Advantage plans, United patients must sort through their options. The Tampa Bay Times contacted both United and BayCare to help answer some typical questions about what happens next.

Is there a deal to extend the contract?

No, the contract between United and BayCare expired Monday. All patients still may use the emergency departments at BayCare hospitals, which include St. Joseph's in Tampa, St. Anthony's in St. Petersburg and the Morton Plant Mease system in mid Pinellas. That's because federal law requires all hospitals with emergency facilities to accept all comers. Other access issues for United customers may vary by plan and individual circumstance.

Could anything change in the future?

Both sides say they are open to continuing discussions, despite the breakdown in negotiations over pricing disputes. United has accused BayCare of demanding unreasonable increases, including a 22 percent hike in employer-sponsored plans.

BayCare contends that it only seeks fair pricing, and has said that United owed it more than $11 million in unpaid bills when the contract dispute became public.

What happens to United patients currently in BayCare hospitals?

No one will be moved unless their physician says a transfer won't harm them.

Plans for continuing care vary by medical situation and coverage type, so patients should call the customer service number on the back of insurance cards for details.

In general, the insurer is working to transfer patients from BayCare facilities to other regional hospitals in its network — which includes 21 general hospitals in the Tampa Bay area — when their physicians consider it medically appropriate.

I'm a pregnant woman planning to deliver at a BayCare hospital. Can I still do so?

Under state regulations, Medicaid patients being treated for ongoing conditions can continue using BayCare facilities for up to six months. Pregnancy care can continue until delivery.

Patients with commercial coverage, such as insurance purchased through their employers, should call United to discuss their options.

I'm supposed to have a procedure at a BayCare hospital after the holidays. What happens now?

Some United members with ongoing health conditions may be able to continue receiving care at BayCare facilities, at least for a limited time, with in-network benefits. Call United for details.

For its Medicare Advantage patients, United says it will cover treatments at BayCare facilities with in-network benefits. But BayCare officials say prior approval will be required before it will treat these patients.

I'm a United Medicare Advantage patient. Can I keep seeing BayCare physicians?

United Medicare Advantage patients seeing BayCare physicians can continue to do so. Many physicians practice at multiple hospitals and can refer you to a non-BayCare facility if hospitalization is needed. Still, it's wise to call your doctor's office to learn more.

But BayCare officials caution that new Medicare Advantage customers — those signing up during the current open enrollment period that ends Dec. 7 — will not have such access to BayCare doctors.

Letitia Stein can be reached at lstein@tampabay.com or (727) 893-8330.

With end of United-BayCare contract, what's next for patients? 11/26/12 [Last modified: Monday, November 26, 2012 10:25pm]
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