Prisma Health, UHC reach agreements after months of negotiations

After months of negotiations, Prisma Health and UnitedHealthcare have reached a new multi-year contract allowing UHC patients to be back in network with the hospital system.

“I am pleased that United agreed to equitable reimbursement that reflects the increased costs we incur for the provision of medical care to our patients,” said Mark O’Halla, president and CEO of Prisma Health in a statement. “These terms will allow us to prioritize patients' needs and provide our physicians and hospitals with the resources required to deliver high-quality health care to United health plan members.”

The new agreement was effective July 19 and retroactive to June 1, 2024. This means out-of-network UHC patients who saw Prisma physicians in June will be billed as if they were in the network. But, patients who saw Prisma’s doctors before June will still be billed out-of-network.

More: UnitedHealthcare no longer in network with Prisma Health. What this means for 58k patients

After failing to reach an agreement in January, 58,000 South Carolinian patients were left out of the network with Prisma Health, the largest healthcare organization in the state. Both healthcare companies placed the blame on each other, with UHC claiming Prisma requested a “nearly 20% price hike.”

Prisma argued it had been able to reach agreements with “all other major insurance companies negotiated with during the past year, recognizing the increased costs that Prisma Health has incurred – all except UHC.” In March, both companies confirmed they remained at the negotiation table. UHC said the insurance company delivered its ninth proposal.

Savannah Moss covers politics for the Greenville News. Reach her at smoss@gannett.com or follow her on X @Savmoss.

This article originally appeared on Greenville News: Prisma Health, UHC reach agreements after months of negotiations