Johns Hopkins Patients Face Insurance Uncertainty with UnitedHealthcare

About 60,000 patients at Johns Hopkins in Maryland might lose their in-network insurance coverage beginning August 25 if the hospital and UnitedHealthcare fail to finalize a new contract.

Negotiations have been ongoing for several months. While both parties agree on the payment rates for doctors, the main contention lies in how medical care is approved and reimbursed.

Johns Hopkins described certain practices by UnitedHealthcare as “harmful,” pointing to issues like “aggressive refusal to authorize necessary care,” forced delays for treatment, and significant lag times in payments that hinder care delivery.

In response, UnitedHealthcare accused Johns Hopkins of seeking contract terms that could be detrimental to employers and patients. “We’re excited to help out,” commented Joseph Ochipinti, the CEO for the Mid-Atlantic region. “But Johns Hopkins is insisting on terms that could negatively impact both members and employers, which could leave patients in a difficult spot.”

This contract dispute affects Johns Hopkins providers in Maryland, Virginia, and Washington, D.C. However, UnitedHealthcare stated that the Hopkins location in Florida will still be considered in-network, regardless of the outcome.

If no agreement is reached, Johns Hopkins hospitals will be out-of-network starting August 25 for patients enrolled in specific UnitedHealthcare plans, which include:

• Employer-sponsored commercial plans
• Individual Family Planning (IFP)
• Dual Special Needs Plan (DSNP) and Medicare Advantage Plans
• Medicaid

Moreover, starting August 25, Johns Hopkins doctors will no longer participate in the employer-sponsored commercial network. They are also currently excluded from UnitedHealthcare’s Medicare Advantage or Medicaid networks.