Rick Sontag donated a Ponte Vedra villa to a brain cancer foundation he established after his late wife's brain tumor diagnosis
* Patients are increasingly caught in disputes as health insurers and providers fail to agree on contract terms.
* A Florida cancer patient was forced to change his insurance plan to keep his doctors at a top cancer center.
* Experts say these contract disputes are a national trend, driven by rising healthcare costs and changes in government funding.
* Hospitals report that insurance reimbursements are not keeping pace with their own rising expenses for staff, supplies, and medication.
Danny DeJarnette, fighting a battle with late-stage cancer, found himself on the lines of another struggle: His insurance no longer gets him in the door as an insured patient where he's being treated.
H. Lee Moffitt Cancer Center in Tampa, one of two Florida facilities designated a comprehensive cancer center by the National Cancer Institute, stopped taking his Aetna Medicare Advantage plan starting this month.
For the 67-year-old Lakewood Ranch father of four who works as a production editor for the USA TODAY Network, the same company that owns The Palm Beach Post, getting diagnosed with lung cancer was enough of a surprise: He's never smoked.
After a false pneumonia diagnosis, a pulmonologist sent him to an oncologist. That cancer doctor was able to identify a cancer marker that pointed to a specialized treatment plan.
The prospect of losing the doctors he had come to rely on at Moffitt sent him reeling.
"I'm sure there are other competent doctors elsewhere, but you know you're going through this, you think you're progressing, and then, boom, you get an email which says, come Dec. 1, no Moffitt for you," said DeJarnette, whose health is backed by one of the country's five largest insurers. "Yeah, that kind of sent me scrambling."
DeJarnette's story -- being faced with changing doctors amid illness -- is likely to become a more common one.
Increasingly, patients are caught in the middle as insurer breakups with health providers are becoming more frequent.
Getting care at a health provider that's not in your health insurer's network could expose you to catastrophic health care costs even with gold-plated insurance.
A national trend with health insurance
It's happening all over the country, said Arthur Novseletsky, senior vice president at Brown & Brown Insurance, one of the largest insurance brokerages in the world, citing a split between United HealthCare and Johns Hopkins Medical Center, one of the world's top-ranked medical centers.
What he's seeing now was unheard of when he began in insurance, Novoseletsky said. If complications arose as health providers and insurers hammered out what care would be covered to policyholders at what cost, the two sides usually managed to work it out before the existing contract expired.
Now, the most popular health insurance in Florida, Florida Blue, hasn't been accepted at Fort Lauderdale-based Broward Health since July 1 or at the Hollywood-based Memorial Healthcare System starting Sept. 1. On a smaller scale, doctors and doctor groups are also going out of network for even big insurance companies.
"I've been in this business for more than 20 years. I've never seen Blue Cross (officially known as Florida Blue) lose such a large hospital system over such a long period of time," Novoseletsky said.
For nonemergency care, patients must use doctors and hospitals included in their health insurer's network for the cost of services to be covered. Health insurance agents say the choices offered by even the country's largest health insurers are getting narrower and narrower as hospitals, and that doctors can't agree with insurers on the terms under which care will be provided and the prices that will be paid when the insured patient accesses the care.
Other insurer-provider splits that are about to happen or already in effect are:
* Tenet Healthcare and Cigna: The contract between the Palm Beach County's largest hospital system and the country's fourth-largest insurer expires Dec. 31.
* Moffitt Cancer Center and Florida Blue Medicare Advantage lines: Dec. 31 is the last day the insurance is accepted there.
* Sarasota Memorial Hospital and Humana: Sarasota's County's public hospital stopped accepting Humana in 2019 and an affiliated physician's group, First Physicians Group, stopped accepting Humana insurance Jan. 1, 2025.
Other recent interruptions in access for those insured through major companies include:
* Sarasota Memorial stopped taking Cigna starting in 2020, and only rekindled their relationship in October.
* University of Florida Health hospitals and its physicians stopped taking United HealthCare on Sept. 1, 2024, and access for United HealthCare policyholders was restored in April 2025.
Why now?
Brown & Brown's Novolseletsky attributes the increased interruptions between providers and insurers to the oncoming effects of One Big Beautiful Bill Act, passed by Congress and signed into law by President Donald Trump this year.
In addition to rolling back taxes on Social Security and funding the Trump administration's efforts to enforce laws regarding undocumented immigrants, the measure that delivered on a host of Trump's priorities also cuts federal funding to Medicaid by nearly $1 trillion over the next 10 years.
The cut in the federal funding, which along with state money helps pay for health care for those on the lowest income tiers and those with disabilities, means less money flowing to hospitals, Novoseletsky said. And the health-care providers are under pressure to get more money from insurers such as Aetna, Cigna, United HealthCare and others.
Also driving the cost: Advances in medicine and drugs that are more expensive than therapies of the past.
"Their costs of care are going to go up, and they are not getting the same government funding they had before, and they are trying to play hardball getting higher contract rates from the commercial insurers," Novoseletsky said.
Hospitals feeling a squeeze
Mary Mayhew, president and CEO of the Florida Hospital Association, sees issues broader than the recent legislation creating financial friction between insurers and providers.
While the majority of providers' expenses -- employee pay, supplies, medication -- have risen 30% in the last three years, the reimbursement rates they are being offered by insurance companies, who manage Medicaid, Medicare and employer plans, are hardly budging, she said.
According to health care researcher KFF, Medicaid, which paid for 42% of all Florida births, reimburses hospitals for 48 cents of every dollar of costs for labor and delivery. And what hospitals can get for providing other services must make up the gap between that cost and Medicaid reimbursement. Psychiatric services and drug rehab fall into the same category: The reimbursement doesn't come up to the actual cost, Mayhew said.
"Those are the reasons why hospitals find themselves between a rock and a hard place in these negotiations with insurance companies," Mayhew said.
Also costly and hurting health providers' cash on hand: The administrative force that must be brought to bear to get the money out of the insurers. In a recent Florida Hospital Association survey, nearly half its members reported having a cumulative $4.8 billion in claims older than 30 days, Mayhew said.
"The other factor that is playing into this is just the administrative burden and expense of hospitals having to chase authorizations, get approval from insurance companies to deliver health care services that clinicians are recommending, and then to chase payments for care that has been provided and that was authorized by the insurance company," Mayhew said.
A cancer story
DeJarnette will tell you he's fortunate in the twist of fate that included the diagnosis of non-small cell cancer adenocarcinoma that he heard two years ago this month -- even if the first biopsy's finding of Stage 3 turned into Stage 4 after the second biopsy.
"When the oncologist gave me his updated diagnosis based on his biopsy he said, '... Sometimes Stage 4 is actually easier to treat than Stage 3," DeJarnette said. "... Because he detected a particular marker in my blood, he said I was eligible for a drug ... that had been found to be an effective pill against my particular cancer, and within a week I was on it."
This pill, without insurance, would cost $500 per dose, and he must take it every day, DeJarnette said.
So far, with the help of his faith and his treatment, things are progressing medically, he said. Next up: radiation.
He has high praise for the care he's received at Moffitt, from its location near his daughter's college classes to the doctors to the valets.
"The first guy we spoke to at the valet said in a warm, loving voice, 'I hope your visit turns out to be a blessing,' " DeJarnette said.
But then he started getting notices that Aetna was dropping not only Moffitt, but also his cardiologist, dermatologist and his primary-care physician.
At first, he thought he had to change providers, but then he decided to change insurers. It's an option because Medicare open enrollment comes around every year.
But he said he's been thinking about all those people who don't have the option of changing up their insurer if the insurer drops their health care providers because it comes through their jobs. DeJarnette was in limbo for the month of December, waiting for 2026 to kick in with his new insurance.
"I was blessed with options," he said, of his decision to change to Humana, which has Moffitt and his other doctors in their network. "Nevertheless, I think of the thousands of people out there getting the same message (about their insurer network dropping their doctor or hospital) I got and not all of them have the same options that I did."
Anne Geggis is the insurance reporter at The Palm Beach Post, part of the USA TODAY Florida Network. You can reach her at ageggis@gannett.com.Help support our journalism. Subscribe today