June 21, 2016

UNM, UnitedHealth part ways on Medicaid contract

Andy Lyman

University of New Mexico Hospital

About 2,000 UnitedHealthcare of New Mexico Medicaid patients who get their care at the University of New Mexico Hospital will have to find new providers as UNM said Tuesday that it has been unable to reach an agreement with United to serve those patients.

Those patients will have to find new doctors by the end of the month, as the contract between UNMH and United expires on June 30.

“Beginning next month, UnitedHealthcare Centennial Care members will no longer be covered for elective services from UNM hospitals, clinics and physicians, including primary care doctor visits, specialist visits, and non-emergency surgeries and medical tests,” UNMH said in a news release

“While we were unable to reach an agreement with UnitedHealthcare in this challenging financial environment, UNM remains committed to providing our patients with access to the best care and service,” said Dr. Michael Richards, physician-in-chief for UNM Health System. “We are doing everything we can to minimize any disruption for patients.

United is one of four insurers who are part of the state’s $4 billion Medicaid, or Centennial Care program. The insurer has 86,380 members in the state. For the first quarter of 2016, United reported a profit of $10.8 million on revenue of $226.4 million.

United’s Medicaid patients who want to continue getting their care at UNM can switch their coverage to a Medicaid insurer that does have a contract with the university. Patients can call the UNM Hospital help line at 505-272-7878.

As of May, there were 863,358 New Mexicans on Medicaid, which is the joint federal/state health care program for low-income people. That represents 41 percent of the state’s population.