Prisma no longer part of United Healthcare network as agreement not reached

File photo

COLUMBIA, S.C. (WOLO)– A lot of Prisma Health patients are now out-of-network as the health care system has failed to reach an agreement with United Healthcare.

The two companies have been in contract negotiations for months, but were not able to come to an agreement by the end of 2023.

Prisma Health says an agreement could not be reached due to UHC’s refusal to enter a reasonable agreement that reimburses the hospital for the cost increases they have and continue to absorb for their health plan members.

A major point of the negotiations has been how much United Healthcare reimburses Prisma for its services.

“We remain at the negotiating table and ask that UnitedHealthcare provide a reasonable proposal that would quickly reinstall Prisma Health as an in-network option,” said Tammie C. Epps, Director, Media Relations & Social Media.

As the issue impacts multiple patients the two companies are blaming one another for the loss of coverage.

United Healthcare has accused Prisma Health of demanding a 20%-plus price hike for employer sponsored commercial plans over the next year.

“Prisma’s proposal would increase health care costs by nearly $60 million for our employer-sponsored plans, which is not affordable or sustainable for South Carolinians and employers,” said a statement by United Healthcare.

Prisma says the increase request is less than 10% over the course of two years and denies UHC’s statement.

Both companies say they are continuing to negotiate and claims the other needs to make “reasonable” proposals.