Johns Hopkins informed us on Sept. 15 that it is walking away from our negotiation because we will not agree to language that would allow them to turn employees and patients away from receiving care based on their own criteria and discretion.
We were preparing to send a counter proposal on contract language later in the week. Johns Hopkins told us not to bother sending the proposal unless it included language that allowed them to have the right to terminate employers from receiving benefits and care at their health system.
Johns Hopkins’ demands are unacceptable. We will not allow any health system to turn patients away at their discretion. We expect network providers to honor their commitment to care for the individuals and families who rely on them as in-network providers. A provider who selectively and unilaterally turns patients away—regardless of medical need or coverage—undermines the foundation of what it means to be a network provider.
Our top priority at this time is supporting members with serious health conditions who are eligible for continued care at Johns Hopkins. We continue to expedite approvals for members who are eligible for continuity of care, despite Johns Hopkins’ refusal to provide the standard clinical and physician information required for this process—information that every other provider in our network shares.
We will remain at the negotiating table and ask Johns Hopkins to do what’s right for the people we serve by providing access to care for all patients.
However, given Johns Hopkins current position, we want to remind you that our members continue to have access to a robust network of providers we collaborate with to provide quality, affordable care. More than 120 hospitals, approximately 12,000 primary care physicians and more than 27,000 specialists continue to participate in our network throughout Virginia, Maryland, and Washington, D.C. Some examples of health systems remaining in our network include but are not limited to MedStar Health, University Maryland Medical System, INOVA Health, Privia Health and many more which remain long-term partners of UnitedHealthcare.
Johns Hopkins Medicine chose to leave our network and disrupt access to care for the people we serve
Despite our repeated efforts to compromise, Johns Hopkins Medicine maintained its demands for contractual provisions that would harm employers as well as our members. Rather than accepting our proposal to extend our contract while we continue our discussions, Johns Hopkins refused and chose to disrupt care for the people we serve.
As a result, Johns Hopkins’ hospitals and facilities in Maryland, Virginia and Washington D.C. are now out of network for people enrolled in the following plans, as of Aug. 25.
- Employer-sponsored commercial plans
- Individual Family Plan (IFP)
- Medicare Advantage plans, including Dual Special Needs Plan (DSNP) and Group Retiree
- Medicaid
Johns Hopkins physicians are also out of network for people enrolled in employer-sponsored commercial plans, as of Aug. 25. The health system’s physicians did not participate in our Medicare Advantage or Medicaid networks.
Johns Hopkins providers delivering behavioral health services who were in the Optum Behavioral Network prior to Aug. 25 remain in our network.
People enrolled in the Veteran Affairs Community Care Network (VACCN) are not impacted. They continue to have network access to Johns Hopkins.
Our goal has always been to reach an agreement. We value the care Johns Hopkins provides and want them in our network. That is why we agreed to the rate increases Johns Hopkins sought, including reimbursing its physicians at rates higher than other physician practices affiliated with some of the top health systems in the country.
We repeatedly compromised and met frequently with Johns Hopkins with the goal of finding a middle ground. Unfortunately, Johns Hopkins maintained its demands for provisions no health system in our network has. They also sought language in our contract that would give them the ability to refuse treatment for any employer it does not want to do business with, reserving the right to turn away UnitedHealthcare members at its discretion as an in-network provider.
We recognize this is deeply personal for the people and families we serve. We will remain at the negotiating table as long as it takes to reach an agreement. We urge Johns Hopkins to join us there with a realistic proposal that protects consistent, equitable access to care. However, our focus at this time is providing people with access to the care they need through either continuity of care or a smooth transition to a new provider, as appropriate.
If you are in active or ongoing treatment for a serious or complex condition at the time Johns Hopkins left our network, you are eligible for continuity of care. Please see more information below as well as on our FAQs. If you have questions or need assistance with continuity of care or finding a new provider, please call us at the number on your health plan ID card. Our dedicated team of customer care advocates are here to help.
FAQs about our negotiation with Johns Hopkins Medicine
This isn’t about money. We’ve reached agreement on financial terms. What Johns Hopkins is inexplicably demanding are contractual provisions that would harm our members and employers. At its core, this is about protecting access to care. As an in-network provider, Johns Hopkins should not have the discretion to turn patients away.
We have a responsibility to uphold our members’ ability to rely on our network for consistent, equitable access to care they need. Johns Hopkins is demanding language in its contract that would give them the right to refuse treatment for any employer it does not want to do business with. In other words, the health system is attempting to reserve the right to turn away UnitedHealthcare members at its discretion as an in-network provider. This is unacceptable.
Our priority is providing people with consistent, reliable and broad access to care. We expect Johns Hopkins to deliver on its commitment to provide care to the individuals and families who rely on them as an in-network provider. A provider who selectively and unilaterally turns patients away—regardless of medical need or coverage—not only undermines the foundation of what it means to be a network provider, but also erodes trust in the U.S. health care system by disrupting equitable access to care.
Johns Hopkins is demanding that UnitedHealthcare be responsible for claims it mistakenly submits to us when the patient is not a UnitedHealthcare member.
We proposed to extend our current contract to allow our organizations additional time to continue our discussions. Johns Hopkins refused.
This would have provided continued network access to Johns Hopkins while we continue to negotiate. Johns Hopkins refused, choosing to allow our contract to expire and disrupt access to care for the people and families we serve.
Johns Hopkins’ has spread false allegations regarding how we process claims. Johns Hopkins experience is consistent with claims approvals data we’ve reported publicly:
Get the facts: How many claims are denied?
If you are in active or ongoing treatment for a serious or complex condition with a Johns Hopkins provider at the time they left our network, you are eligible to continue care for a period of time at in-network costs.
Continuity of care allows people in ongoing or active treatment for a serious or complex condition at the time a provider leaves our network to continue accessing care with their provider at in-network rates for a period of time. These conditions include individuals who are undergoing institutional or inpatient care, are scheduled to undergo nonelective surgery from the provider, are terminally ill, or are pregnant.
Any member who believes they need continuity of care should contact UnitedHealthcare to determine if they are eligible. For information regarding how to apply, whether you might be eligible for continuity of care and much more, please call the number on your health plan ID card. Our dedicated team of advocates are ready to assist you with all your health care needs.
Additionally, UnitedHealthcare fully insured members whose plan is sitused in Maryland have the right to receive services from their designated Johns Hopkins primary care physician (PCP) at in-network costs for up to 90 days from the date members received a letter from us notifying them of the termination. We have sent follow-up letters to eligible members.
You can receive in-network care from any Johns Hopkins PCP no matter where they are located, so long as your fully insured commercial plan is sitused in Maryland, in accordance with Maryland state law. UnitedHealthcare is taking steps to automatically approve the care received as in-network.
UnitedHealthcare fully insured members who were receiving services from a Johns Hopkins PCP but have not received a letter can still contact UnitedHealthcare to confirm their eligibility and/or request continuation of these benefits by calling the Member Service phone number on their health plan ID card.
In order to minimize disruption for our members, we are also applying continued care at in-network costs for Johns Hopkins PCPs for people enrolled in ASO (also known as self-funded) commercial plans.
This benefit only applies to Johns Hopkins PCPs. Johns Hopkins other providers and facilities are out of network for non-emergent services, unless approved for continuity of care.
We know Johns Hopkins choosing to leave our network is difficult. We want you to know you continue to have access to a broad network of hospitals and physicians throughout Maryland, Virginia and Washington D.C.
If you have questions or are in need of assistance finding alternative providers in your area, please call us at the number on your health plan ID card. You can also use the provider directory at myuhc.com to search for alternative hospitals and physicians in your area.
You should always go to the nearest hospital in the event of an emergency. Services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.
Our commitment to you and your family’s health care needs
We know your relationship with your doctors are deeply personal and important, and we understand you are rightfully concerned by this news. We want to reassure you we are doing everything we can to reach an agreement and we will remain at the negotiating table as long as it takes. However, we need Johns Hopkins to provide a proposal that protects patient access to care.