Tag Archives: contract

Aetna Chosen As Subcontractor In Qatar’s Universal Health Care Coverage

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Aetna has a key role in Qatar’s new national health care system.

The Hartford health insurer was chosen to help the National Health Insurance Company of Qatar in developing a disease management program and to help generally in improving the country’s health insurance program.

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Anthem, Middlesex Hospital Reach Contract Agreement

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Anthem Blue Cross and Blue Shield in Connecticut and Middlesex Hospital announced Friday afternoon that they have reached a multi-year contract.

The agreement ends a months-long standoff that led to Anthem dropping Middlesex Hospital from its network on Monday, when the previous contract expired. That left Anthem customers faced with either paying higher, out-of-network rates at Middlesex Hospital or going elsewhere for medical services.

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Anthem Customers Face Out-of-Network Rates At Middlesex Hospital After Contract Expires

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MIDDLETOWN — People who have Anthem Blue Cross and Blue Shield in Connecticut as their health insurer will face more expensive, out-of-network rates at Middlesex Hospital starting Jan. 1.

Anthem, the state’s largest health insurer in terms of membership, and Middlesex Hospital have negotiated terms of a contract for months, but the two sides were unable to agree on a deal, according to Wallingford-based Anthem.

The previous contract ends Monday, Dec. 31, 2012. This is the most recent in a continuing series of contract battles between health insurers and hospitals. In general, insurers argue that they are trying to hold down medical costs for customers while hospitals say they are only asking the price to provide quality treatment for patients.

“We value this hospital and their role in our network; however, the level of increase they are demanding is unreasonable to pass along to our customers,” said Anthem spokeswoman Sarah Yeager.

Anthem told its members earlier in December that Middlesex Hospital could be eliminated from the insurer’s network of medical providers if the two sides didn’t agree on a contract by the Dec. 31 deadline. Anthem is referring its members to other hospitals.

Neither the hospital nor the insurer on Monday would say how many patients who have Anthem have used the hospital’s services in the past year. The sticking points also aren’t clear, though in many contracts, the insurer and hospital disagree about the price the insurer should pay for services, such as surgeries, x-rays, diagnostic tests and other clinical costs.

“We’re fortunate that we have other in-network providers and hospitals in the area and throughout Connecticut who can meet our members’ health care needs,” Yeager said.

Middlesex Hospital declined to comment beyond acknowledging that the contract was set to expire Monday.

Hartford Hospital “Hopeful” In Negotiations With UnitedHealth Group As Sunday Deadline Nears

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Hartford Hospital is “hopeful” in its negotiations Friday with UnitedHealth Group. Thousands of patients face higher, out-of-network rates if the two parties don’t have a new contract by the time the current agreement expires at midnight Sunday.

The nation’s largest health insurer and the hospital have been in a bitter dispute over reimbursement rates the insurer will pay the hospital for medical services. On Friday, however, the talks may have taken a turn.

“We are talking and we are hopeful,” said Hartford Hospital spokeswoman Rebecca Stewart.

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Hartford Hospital Says UnitedHealth’s Claims About 30% Rate Hike Are ‘Factually Wrong’

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Hartford Hospital says the rate increases it is asking of UnitedHealth Group is “not even close” to the 30 percent that the insurer says the hospital wants over the course of three years.

“That is factually wrong — not even close,” Hartford Hospital spokeswoman Rebecca Stewart said Wednesday.

The hospital is seeking an increase to reimbursement rates that is slightly above the medical inflation rate, which she says is 5.9 percent. The hospital would not, however, say what percentage increase in rates it wants each year, other than Stewart saying “around 6 percent.”

Neither UnitedHealth nor Hartford Hospital will give the actual dollar amounts of proposed rates, which could be compared with current rates to verify one or the other’s argument. The proposed rates are often considered proprietary information during any negotiation between an insurer and a hospital. In recent years, however, the public has been given a closer look at sticking points in these type of negotiations as consumers complain about the price of medical coverage.

UnitedHealth stands by its statement, said company spokesman Daryl Richard. The parent company for Oxford and UnitedHealthcare health plans says consumers will pay 30 percent more over the next three years for services received at Hartford Hospital.

“In practical terms, that means the average cost for a two-day hospital stay after delivering a baby would increase by as much as $650, and the average cost of outpatient surgery, such as arthroscopic knee surgery, would increase by almost $300,” Richard said in an e-mail Tuesday.

The region’s largest hospital, and its affiliate The Hospital of Central Connecticut in New Britain and Southington, are battling the nation’s largest health insurer in contract negotiations that have dragged on for more than seven months. The current contract expires Oct. 28 and could mean that thousands of patients will face higher, out-of-network rates for hospital services.

The debate is centered on reimbursement rates that the hospital charges the insurance company for medical services such as surgeries and diagnostic tests.

Hartford Hospital sent letters in late September to notify 26,783 people who were patients at either of the two hospitals in the past 12 months and had UnitedHealthcare or Oxford health insurance or Medicare Advantage plans. That number comprises 9,500 for Hartford Hospital patients and 17,283 for The Hospital of Central Connecticut. UnitedHealth said it sent letters to about 6,800 members who might face higher, out-of-network rates if a new contract is not in place by Oct. 28.