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Midnight looms in hospital standoff

The contract between United Healthcare and HCA, which runs nine bay area hospitals, expires today.

By KRIS HUNDLEY
Published August 29, 2006


Q&A: HCA AND UNITED HEALTHCARE

What does that mean for United Healthcare's members?

It means the insurer will not pay for procedures performed at HCA hospitals. United Healthcare's members will continue to have coverage at non-HCA hospitals in the area, however. These include Tampa General, St. Joseph's and University Community hospitals in Hillsborough and Bayfront Medical Center and Morton Plant Mease in Pinellas.

Which local hospitals are owned by HCA and will be out of the United network?

Oak Hill Hospital in Hernando County; Regional Medical Center Bayonet Point and Community Hospital New Port Richey in Pasco County; Largo, Northside, St. Petersburg General and Edward White hospitals in Pinellas County; and Brandon and South Bay hospitals in Hillsborough County.

What happens if I have a medical emergency?

In true medical emergencies, you should go to the nearest hospital, regardless of whether it is part of your insurance network. United will cover treatment in an emergency situation regardless of where the care is provided. Once your condition is stabilized, you will be moved to a hospital in the United network.

The nation's largest hospital chain and one of the Tampa Bay area's biggest insurers are still haggling over terms of a contract set to expire today at midnight.

Barring resolution or a contract extension, nearly half a million members of United Healthcare will lose access to nine local hospitals owned and operated by HCA of Nashville.

Neither party was discussing the stalemate on Monday, though a United spokesman acknowledged that no agreement had been reached. Dave Libby, director of personnel for Pinellas County, which has about 8,600 employees, retirees and dependents insured through United, said he hadn't heard a thing since an HCA executive urged him and his workers to lobby on its behalf several weeks ago.

"I intend to stay out of it and I told our people to stay out of it," Libby said. "I also told them our insurance would continue to cover them at an HCA hospital in an emergency situation."

But unless the two sides reach an agreement, United's members will have to arrange for most diagnostic and surgical procedures to be handled by non-HCA hospitals or pay higher, out-of-network fees for HCA's services.

Though that might mean changing doctors for some United members, most physicians are on the staffs of several hospitals.

The contract deadlock comes at a time when both HCA's and United's finances have been in the news. HCA has announced plans for a $23.3-billion leveraged buyout by current management and equity groups. If approved, the new company will have $11.7-billion of debt. HCA had earnings of $1.4-billion last year on revenues of $24.5-billion.

United, which had 2005 earnings of $3.3-billion on revenues of $45.4-billion, is under both civil and criminal investigation by federal officials regarding its pricing of executive stock options.

At the end of last year, United's chief executive, Dr. William McGuire, had gains from unexercised options worth $1.8-billion.

Kris Hundley can be reached at hundley@sptimes.com or 727 892-2996.

[Last modified August 29, 2006, 00:19:03]


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