Maryland patients hope for last-minute insurance agreement between Johns Hopkins, UnitedHealthcare

Nearly 60,000 Johns Hopkins Medicine patients in the Maryland area could lose insurance coverage under UnitedHealthcare (UHC) on Monday.

The two organizations have been at an impasse for months and have failed to reach an agreement that would keep these patients covered. 

WJZ spoke with a patient advocate on Friday, who said this will hit particularly hard for those who need transplants. 

Johns Hopkins patients in Limbo

Jamie Imhof has had two transplants, a liver and a kidney, taken care of in the Johns Hopkins Medical system. 

That's why she now helps people around the country with their own transplants. For many in the Baltimore area, it's become a game of wait-and-see. 

"They're real-life people, this is your mother, your father, your sister, your cousin that are going to suffer from what is currently happening," Imhof said. 

Tens of thousands of Maryland patients are set to lose in-network coverage on Monday unless the medical system and health insurance provider reach a contract agreement. 

The dispute centers on how care is approved and reimbursed. 

For transplants, Imhof said it requires many specialized doctors, making it difficult to look for treatment elsewhere, no matter where you are in your transplant journey. 

"Whether they're pre-awaiting transplant, even to a freshly transplanted individual that [as of Friday] may not be able to even see their transplant team on Monday," Imhof said. "There's no way to move care like this."

Ongoing contract negotiations 

In a statement, Johns Hopkins said the medical system has been negotiating in good faith for more than eight months. 

It also claims it is trying to avoid "aggressive claim denials." 

"We will not sign a contract that allows an insurance company to put profits over patients' health and well-being," a spokesperson for Johns Hopkins Medicine said in a statement.

Meanwhile, UnitedHealthcare maintains that Johns Hopkins' terms would negatively impact its members and patients. 

"...the health system is attempting to reserve the right to turn away members at its discretion as an in-network provider," a statement on UnitedHealthcare's website reads. "This is unacceptable."

Imhof is hoping for a last-minute save before Monday.

"Frankly, they need to get this resolved and take care of these people they promised to insure. They need to get this fixed," she said.

In a statement Friday, UHC urged patients undergoing active treatment at Hopkins Medicine to apply for continuity of care before Sunday, Aug. 24.

"Continuity of care allows people in ongoing or active treatment for a serious or complex condition at the time a provider leaves our network to continue accessing care with their provider at in-network rates until their treatment concludes," UHC said.

Who does the dispute impact?

The contract dispute affects Johns Hopkins providers in Maryland, Virginia and Washington, D.C.

Johns Hopkins locations in Florida will remain in-network regardless of the outcome, UnitedHealthcare said.

If no agreement is reached on Aug. 25, patients enrolled at Johns Hopkins hospitals under the following plans will be out of network:

• Employer-sponsored commercial plans
• Individual Family Plans (IFP)
• Medicare Advantage plans, including Dual Special Needs Plans (DSNP) and Group Retiree
• Medicaid

Johns Hopkins physicians will also be out of network for employer-sponsored commercial plans beginning on August 25.