Two national health care industry behemoths have ended a yearslong standoff and reached an agreement that will bring a major Las Vegas hospital in network for more than half a million patients.
Patients insured by Health Plan of Nevada, Sierra Health and Life and Sierra Health-Care Options — subsidiaries of insurance giant UnitedHealthcare — will be able to visit Sunrise Health System’s hospitals, urgent care centers, surgery centers and free-standing emergency rooms, part of the hospital giant HCA’s system, at in-network rates beginning Jan. 1 under the multi-year agreement.
The lack of a contract between the two companies had left thousands of Nevadans insured under the plans vulnerable to out-of-network bills, particularly at Sunrise Hospital, which, as one of three trauma centers in Las Vegas, often receives patients in critical condition unable to make choices about which hospital they want to go to.
Facilities that will be covered the agreement include four hospitals — Sunrise Hospital and Medical Center, Sunrise Children’s Hospital, MountainView Hospital and Southern Hills Hospital and Medical Center — 17 CareNow Urgent Care facilities, four surgery centers, and two free-standing emergency rooms.
Brian Cook, president of HCA Healthcare's Far West Division, said in a statement Monday morning that the agreement will allow both companies "to expand access to quality healthcare."
"HCA Healthcare Sunrise Health System and our affiliated physicians are thrilled that we will have the opportunity to serve Health Plan of Nevada and Sierra Health & Life members with safe, quality care across a broad network of 32 healthcare locations throughout greater Las Vegas," Cook said. "This agreement furthers our purpose to give people a healthier tomorrow."
Laurine Tibaldi, chief medical officer for Health Plan of Nevada and Sierra Health and Life, called the Sunrise Health System an "important care provider" and said that they "look forward to collaborating with them in support of our shared commitment to help the people we serve live healthier lives."
"As Health Plan of Nevada and Sierra Health & Life continue to grow, it’s vital that our network of care providers grows as well so that our members have convenient access to quality health care close to where they live and work," she said.
Legislative leadership were notified of the decision in an email late Friday by an HCA lobbyist.
“We are excited to share news with you that effective January 1, 2020, all of HCA Healthcare Sunrise Health System’s hospitals, urgent care centers, PSG, surgery centers, and free-standing emergency rooms will be in-network with the Health Plan of Nevada (HPN)/Sierra Health and Life (SHL)/Sierra Health-Care Options (SHO)–inclusive of Commercial and Medicaid products,” the email said.
The move will affect more than half a million Nevadans, including the more than 230,000 Nevadans who are in a Medicaid managed care plan run by Health Plan of Nevada, as well as those who purchase Health Plan of Nevada plans on the state’s health insurance exchange and those covered under the companies’ other commercial plans.
The move comes just seven months after the Legislature passed and the governor signed into law a bill, AB469, that will protect patients from getting hit with surprise bills when they receive emergency treatment from out-of-network providers, including hospitals and doctors. The law, which takes effect Jan. 1, will hold patients harmless by requiring them to only pay their in-network copays, coinsurances or deductibles and lays out a process for out-of-network providers to get reimbursed by insurance companies.
Updated 12-9-19 at 9:30 a.m. to include statements from HCA and UnitedHealthcare confirming the new agreement.