Tuesday, December 4, 2018

CityMD may soon be out-of-network for UnitedHealthcare members


By Jonathan LaMantia  | December 4, 2018
UnitedHealthcare has sent letters to members, advising them that the company has yet to extend its contract with urgent-care chain CityMD, and the current agreement is set to expire Dec. 31.

"We are working diligently to continue our contractual relationship with CityMD, a physician group with whom you or a dependent has a relationship," United wrote in a letter obtained by Crain's. "Unfortunately, we have not yet reached an agreement with them, and the deadline for the contract is rapidly approaching. We assure you we are making every effort to reach a successful resolution."

The letter, dated Nov. 26, warns members that they might need to seek out other providers. "Utilizing an out-of-network provider may result in higher costs for you," United wrote.

United noted that some members are eligible for continuity-of-care benefits, which allow patients to continue seeing a provider at in-network costs for a period of time.

United is the nation's largest U.S. insurance company and operates Oxford Health Plans, which insures half of New York's small-group market.

In response to questions from Crain's, a United spokeswoman said, "Our two organizations continue to meet regularly, and our focus remains on renewing our relationship with CityMD."

CityMD has more than 100 locations in New York, New Jersey and Washington. In Manhattan, the urgent-care chain dots the map like subway stops, with 22 clinics. Private-equity firm Warburg Pincus acquired a majority stake in CityMD for an undisclosed price in 2017.

"We are making every effort to reach a successful resolution with UnitedHealthcare so that its members, our patients, continue to have access to CityMD," Angela Profeta, senior vice president of strategy at CityMD, said in a statement.

The dispute is the latest among major health providers and insurers in which members have received such a notice. Montefiore Health System and Aetna clashed this summer, and Empire BlueCross BlueShield and New York-Presbyterian were engaged in a public debate about reimbursement rates last month. Both negotiations were resolved before patients faced higher out-of-network charges. CityMD, while an increasingly common sight in city storefronts, does not offer the same breadth of services as those health systems, though.


"CityMD may soon be out-of-network for UnitedHealthcare members" originally appeared in Crain's New York Business.

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