UnitedHealthcare disputes Prisma Health’s contract breach claims, asserting media manipulation. Prisma Health sought an injunction, temporarily preventing UnitedHealthcare from disclosing further information. Amid negotiations for a new contract, Prisma Health emailed patients about potential network changes, leading to media exposure. UnitedHealthcare responded, alleging Prisma used media tactics to gain negotiation leverage. Prisma Health maintains the email was confidential and intended only for its patients with UnitedHealthcare coverage. The lawsuit centers on UnitedHealthcare’s alleged disclosure of proprietary rate increase details.
UnitedHealthcare has rebuffed the allegations made by Prisma Health, based in Greenville, S.C., asserting that it did not breach its contract and suggesting that Prisma Health orchestrated a media campaign to apply pressure on the insurance company.
Prisma Health accused UnitedHealthcare of violating their contract by revealing details of Prisma Health’s rate proposals to various media outlets without furnishing a copy of the statements to Prisma Health 48 hours before publication. Seeking a temporary injunction to halt further disclosure by UnitedHealthcare, the health system managed to obtain the request on August 31. The court order included an agreement to keep certain case documents confidential. The legal proceedings continue.
UnitedHealthcare, in its response submitted to South Carolina’s 13th District Court on August 29, stated that Prisma Health was responsible for initiating the situation through its media initiatives.
The ongoing negotiations between the two entities involve the crafting of a new contract. Court records reveal that on August 16, Prisma Health sent an email to its patients who were enrolled with UnitedHealthcare, notifying them of a potential cessation of in-network coverage if a new contract agreement wasn’t reached by January 1, 2024.
UnitedHealthcare claimed in its response that media outlets received copies of this email from multiple UnitedHealthcare customers, indicating that Prisma Health tried to employ media exposure and pressure to secure advantageous terms in the contract negotiations. UnitedHealthcare responded to Prisma’s efforts only after being contacted by a reporter regarding Prisma’s communications.
Prisma Health responded on August 30, stating that the email was intended as confidential communication specifically for Prisma Health patients covered by UnitedHealthcare plans. Malcolm Isley, the Chief Strategy Officer of Prisma Health, emphasized in a filed affidavit that the confidential communication was shared exclusively with Prisma Health patients identified as having insurance coverage through a United plan and that its contents were not disclosed to any members of the media.
Prisma Health accused UnitedHealthcare of violating the contract by divulging confidential information about the health system’s proposed rate increases. In its defense, UnitedHealthcare contended that its statements to the media did not entail disclosing proprietary business-sensitive information.
