Particle.news
Download on the App Store

Johns Hopkins Ends UnitedHealthcare Talks, Leaving 60,000 Patients Out of Network

The collapse stems from a dispute over prior-authorization rules versus plan‑exclusion language, not prices.

Overview

  • Johns Hopkins told staff and will notify patients that it will not return to UnitedHealthcare’s network, urging enrollees to seek new providers or consider other coverage during open enrollment.
  • UnitedHealthcare says eligible patients approved for continuity of care can keep seeing Hopkins providers at in‑network rates for up to 90 days from approval.
  • The health system cites onerous authorization and denial provisions that it says impede care, while UnitedHealthcare accuses Hopkins of seeking terms that could exclude certain employer plans.
  • The disruption affects Hopkins providers in Maryland, Virginia and Washington, D.C., with Hopkins locations in Florida and Veterans Affairs Community Care Network enrollees unaffected, according to UnitedHealthcare.
  • Talks stretched more than eight months with multiple deadline extensions before Hopkins declared a stalemate, as UnitedHealthcare says it remains willing to negotiate.