Bronx, N.Y.-based Montefiore Health System may no longer be a part of Aetna’s provider network if the organizations can’t resolve a contract dispute before a Sept. 8 deadline, according to The Journal News/lohud.
In a letter to policyholders obtained by the publication, Aetna notified members they could face higher out-of-pocket costs to access Montefiore facilities and providers — save for emergencies — if a deal is not reached. Aetna said the letter is part of active negotiations with the 11-hospital system.
“Both parties are working in good faith and with a concerted effort to reach a fair and reasonable agreement,” Aetna spokesperson Shelly Bendit told The Journal News/lohud. “Aetna is committed to working with providers to offer affordable and accessible healthcare to our members. We seek agreements that take into account the financial impact on employers and employees in our network.”
However, after The Journal News/Iohud reported the letter, Montefiore told the publication Aetna has demanded unreasonable reimbursement cuts, forcing a stalemate. A Montefiore spokesperson said, “Contract negotiations have stalled as Aetna continues to demand we accept unreasonable cuts that do not appropriately pay for the care we provide.”
Date: Aug 08, 2018