LVHN ends relationship with insurance giant Aetna, tens of thousands expected to be affected

The Lehigh Valley Health Network will stop accepting Aetna insurance next year, according to sources familiar with the announcement. This could result in high out-of-pocket costs for thousands of patients who suddenly lose their network of doctors.

The Health Network sent a letter Thursday to local employers informing them of their decision to no longer accept Etna’s plan effective March 13. A copy of the letter was obtained by Morning Call.

In the letter, LVHN accused the health insurance giant of refusing to pay for medical care provided to Aetna members and regularly denying or delaying patient care over the past five years. The letter states that the network has been trying to resolve these issues since 2017 to no avail.

As a result, if the current contract ends in 120 days, all plans from Aetna and its subsidiaries, including Medicare and Medicaid plans, will not be accepted as in-network at nearly all LVHN-operated facilities. The network has been contracted to Aetna for about 20 years.

Aetna, owned by CVS Health, covers approximately 39 million people in the United States, and the move will affect tens of thousands of people in the Lehigh Valley who have Aetna insurance and are seeing LVHN doctors. may give. The move will not affect emergency care or the types of care that would be dramatically impacted by a loss of continuity, such as cancer treatment, pregnancy care and childbirth care, according to the letter.

After more than a week into the federal open registration period, the move by LVHN comes as an unwelcome surprise to many while many companies are enrolling their employees on next year’s new health insurance plans. must be.

Changing doctors is an option, but the only realistic options for those wanting to keep their doctor are changing insurance providers, paying higher out-of-network fees, paying out of pocket, or waiting until March. That’s it. An insurance company can enter into some kind of contract.

In the letter, LVHN encourages businesses and employees to contact Aetna representatives and ask insurance companies to find solutions with LVHN.

In 2000, when the network was still operating under the name Lehigh Valley Hospital, it announced plans for its next move. Termination of relationship with Aetna due to stalled contract negotiations regarding treatment reimbursement.

LVH fulfilled its promise in March 2001 after failing to reach a mutual agreement. At the time, according to medical networks, thousands of patients were switching insurance companies and staying with their doctors. In 2003, LVH-Muhlenberg, not following other network hospitals, announced it was ending its contract with Aetna.

A new contract was reached in 2007.

LVHN is not the only medical institution to cut ties with insurance companies. Over the past two decades, many other hospitals and medical networks have used the same tactics in their negotiations with Aetna and other insurers.

Wake-up call reporter Leif Greiss at 610-679-4028 or lgreiss@mcall.com.

Leave a Comment