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Healthcare Giants in the Spotlight: UnitedHealthcare vs. Prisma Health

The dispute between UnitedHealthcare and Prisma Health revolves around allegations of breach of contract and the disclosure of confidential information. UnitedHealthcare asserts that it did not breach its contract with Prisma Health and suggests that Prisma Health engaged in a media campaign to exert pressure on the insurance giant. Prisma Health, on the other hand, claims that UnitedHealthcare breached their contract by sharing Prisma Health’s rate proposals with various media outlets without providing a copy of the statement to Prisma Health 48 hours before publication. As a result, Prisma Health requested a temporary injunction to prevent further disclosures by UnitedHealthcare.

On August 31, a judge granted Prisma Health’s request for a temporary injunction, preventing UnitedHealthcare from disclosing additional information. This order also stipulated that certain documents in the case would be sealed. The legal case remains ongoing.

In response to Prisma Health’s allegations, UnitedHealthcare contended that Prisma Health initiated the situation through its own media efforts. Both parties are currently in the process of negotiating a new contract.

According to court documents, Prisma Health sent an email to its patients with UnitedHealthcare on August 16, informing them that if a new contract agreement was not reached by January 1, 2024, the two parties would no longer be in-network providers. UnitedHealthcare alleges that copies of this email were disseminated to media outlets by multiple UnitedHealthcare customers.

UnitedHealthcare asserts that it responded to Prisma Health’s media efforts only after a reporter reached out regarding Prisma Health’s communications. UnitedHealthcare contends that Prisma Health sought to leverage publicity and media pressure to gain an advantage in contract negotiations.

Prisma Health, in its response, argued that the email it sent was intended as a confidential communication for Prisma Health patients who received benefits through UnitedHealthcare exclusively. They claim that the confidential communication was only sent to patients of Prisma Health who, according to Prisma Health’s records, were covered through a UnitedHealthcare plan. Prisma Health further asserts that they did not share the contents of this confidential communication with any media outlet.

Prisma Health’s main allegation is that UnitedHealthcare violated their contract by disclosing Prisma Health’s proposed rate increases, which Prisma Health considered confidential. UnitedHealthcare, in response, maintains that its statements to the press did not reveal proprietary business information. The legal proceedings will likely continue as both parties work towards resolving their contract dispute. ALSO READ: Henrietta Lacks’ Estate Files Gene Therapy Lawsuit Against Ultragenyx

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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