Contract dispute jeopardizes in-network medical care for thousands of Arizona kids

Some patients don't have any other options for treatment.
Published: May. 23, 2023 at 8:55 AM MST
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PHOENIX (3TV/CBS 5) - Diagnosis day was scary. It was January. Madi Walden slept a lot later than usual. “I went in to check on her and she was breathing very, very heavily and just asleep. I could not wake her up,” said Madi’s mom, Misty Walden. She rushed her little girl to the ER that’s near their home. Soon, the eight-year-old was transferred to Phoenix Children’s. After a slew of tests, Madi was diagnosed with Type 1 Diabetes.

“We were at PCH for about a week and since then we have established so many relationships with them, with doctors, educators, psychologists,” Walden said. [Madi] has a diabetic educator that she is very, very close with. We are able to text her or call her with concerns or questions about her blood sugar levels, or things that are happening that we’re still learning. We’re all still learning, and she’s always so responsive and so caring.”

Now, Walden fears they may have to find a new medical team to care for her daughter. Madi has insurance through UnitedHealthcare. The company and Phoenix Children’s are locked in a contract dispute over employer sponsored and individual commercial plans. Patients were notified that beginning June 1, their care may be out of network. “It’s just very scary. It’s very scary,” Walden said. “To give a month notice of having to turn your whole life upside down and find another provider is frustrating. I think I’m just overly frustrated at the entire situation; not at one more than the other.”

According to UnitedHealthcare, treatment for more than 17,000 children could be impacted. Medicaid patients who are covered through the UnitedHealthcare Community Plan in Arizona will remain in-network and are not impacted by the ongoing negotiations.

UnitedHealthcare full statement:

Phoenix Children’s full statement:

“We know businesses are businesses, and I understand that,” Walden said. “Unfortunately, it’s about money for both of these places, and I really wish that the patients could just be the center focus of all of this.”

According to Phoenix Children’s and UnitedHealthcare, emergency care will not be out of network, regardless of what happens with negotiations. Patients can still go to Phoenix Children’s ER and use their UnitedHealthcare coverage at in-network pricing, but Phoenix Children’s urgent care would be out of network after May 31st.

Patients who are in the middle of treatment, for example for cancer, can apply for continued care under in-network costs. Patients with questions about their coverage should contact UnitedHealthcare using the phone number that is on the back of their insurance card. Phoenix Children’s and Cigna had their own contract dispute and reached an agreement earlier this year.