• Sarasota Memorial Hospital and UnitedHealthcare are at a deadlock in their contract negotiations, with the current agreement set to expire on December 31. This impasse risks disrupting coverage for thousands of UnitedHealthcare Medicare Advantage enrollees in Sarasota.
• Negotiations have been ongoing since August but are hindered by issues specific to Medicare Advantage programs, such as lower reimbursement rates and frequent denials of coverage, in contrast to traditional Medicare.
• If a new contract is not agreed upon by January 1, 2024, Sarasota Memorial’s facilities will become out-of-network for UnitedHealthcare Medicare Advantage members.

Negotiations between Sarasota Memorial Hospital and UnitedHealthcare remain at a standstill, with the looming expiration of their current contract just days away. The impasse threatens to disrupt health coverage for thousands of UnitedHealthcare Medicare Advantage enrollees in Sarasota.

Per a public notice page maintained by the hospital, Sarasota Memorial states it has been engaged in discussions with UnitedHealthcare since August, though talks have “been complicated” by issues with Medicare Advantage programs, including lower reimbursement rates and frequent denials of coverage compared to traditional Medicare. The current contract between the two entities is set to expire on December 31.

“We have been working diligently for several months to reach an agreement with UnitedHealthcare before our current contract expires on Jan. 1, 2024. In recent days, we have made significant progress, and we are optimistic we will reach an agreement for both United’s Medicare Advantage and Commercial plans before the end of the year,” said Sarasota Memorial Hospital. “We continue to engage in active, productive discussions with United, and are prepared to work around the clock.”

Should the parties fail to reach an agreement by the year-end deadline, Sarasota Memorial’s facilities of practice will become out-of-network providers for UnitedHealthcare Medicare Advantage members starting January 1, 2024.

“Our top priority is to reach an agreement that ensures people enrolled in our employer-sponsored commercial plans and Medicare Advantage plans have continued access to Sarasota Memorial Healthcare System’s hospitals, facilities, and physicians at an affordable cost,” said UnitedHealthcare. “We continue to make meaningful progress toward a new agreement and are committed to utilizing the time remaining on our contract to reach a new, long-term agreement.”

In past updates, Sarasota Memorial posited that the process of renewing contracts has been broadly complicated by issues related to Medicare Advantage programs both locally and nationwide. The healthcare provider claimed that many health systems have opted out of contracts with such plans because they offer “lower reimbursements compared to traditional Medicare” and “frequently deny coverage or restrict essential care.”

“This year, contract renewals have become more complex due to challenges patients and their care providers are experiencing locally and around the nation with certain Medicare Advantage programs,” wrote Sarasota Memorial. “Recently, a number of health systems have chosen to end their contracts with Medicare Advantage plans because they reimburse far less than traditional Medicare and routinely deny coverage and limit necessary care.”