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San Francisco health board urges UCSF and UnitedHealthcare to resolve Medicare Advantage dispute
Summary
The San Francisco Health Service Board unanimously directed Executive Director Abby Yant to press UnitedHealthcare and the UCSF Medical Group to convene immediate negotiations and to provide clearer member communications after retirees and union representatives reported canceled appointments and confusing notices.
The San Francisco Health Service Board on Aug. 10 unanimously adopted a motion directing Executive Director Abby Yant to press UnitedHealthcare and the UCSF Medical Group to convene meetings that exchange specific proposals to resolve a dispute affecting Medicare Advantage members.
Board members and staff described a patchwork of member experiences: some claims were continuing to be processed, while others reported canceled or blocked appointments after UCSF indicated it might configure systems to refuse new appointments around June 30. Executive Director Abby Yant told the board, “Our members are kind of stuck in the middle,” and said SFHSS is engaging UnitedHealthcare and other employer groups to press both parties to reach an agreement.
The motion, moved by President Scott on behalf of the board and seconded, directed the executive director to (1) continue discussions with UnitedHealthcare and UCSF, (2) work with the UCSF Medical Group so accurate, sensitive and timely information is provided to SFHSS members trying to schedule appointments, and (3) convene negotiations aimed at a workable contractual solution. The board voted by roll call and the motion carried unanimously.
Public comment strongly supported the motion. Retiree and union speakers described recipients of mailed notices from UCSF who were told UCSF would not accept UnitedHealthcare Medicare Advantage as an in-network reimbursement mechanism. Fred Sanchez, speaking in person, said the change threatened retirees—ability to pay for basic living expenses and urged the board to "protect our benefits." Union representatives and multiple emailed commenters asked the board to use whatever influence it has to speed a resolution.
Yant said UnitedHealthcare has trained its customer-service staff to provide more consistent information but that inconsistencies have persisted at the university—s scheduling and billing offices. Yant recommended caution about broadly notifying members before the board had clearer, agreed facts; staff are drafting a notice under review by UnitedHealthcare and said they balance the risk of "worry calls" against the need to inform members ahead of open enrollment.
Next steps: the board—s motion asks Yant to keep negotiating with both sides and to ensure member communications are accurate and timely; staff said they will return to the board with updates as discussions proceed. The board did not direct any contractual change or budgetary action in today—s vote.
