TOLEDO, Ohio — The contract between ProMedica and Cigna insurance terminated Monday after contract negotiations failed, causing Cigna members to lose in-network access to ProMedica facilities.
The contract terminated after the two companies failed to reach an agreement in negotiations over a new contract. According to Cigna, ProMedica demanded a 15% increase, which the insurance company argued would make health care much more expensive for their members.
In a statement from ProMedica in March, the healthcare company said it entered a short-term agreement with Cigna in 2022. The statement said ProMedica and Cigna had been negotiating for several months to reach a renewed contract, but had not come to an agreement.
This means patients will no longer receive in-network coverage at ProMedica facilities. Patients will be responsible for 100% of their billed charges at ProMedica out-of-network facilities, according to its website. The website also says patients can request an out-of-network waiver from Cigna for procedures they may schedule to receive.
A Cigna spokesperson released the following statement Monday regarding the contract's termination:
It is disappointing that ProMedica is forcing our shared patients to lose in-network access to their facilities by choosing to leave our network April 1. Their unreasonable demands for a 15% rate increase would make health care much more expensive for the people we serve. We hope that ProMedica will step up for patients and reconsider their decision to leave our network.
Any health care transition can be challenging, and we are committed to helping our customers find other conveniently located physicians. Women who are pregnant or customers receiving ongoing medically necessary care may be able to continue that care with ProMedica at the in-network benefit rate under their plan’s Continuity of Care guidelines. Our customer service advocates are available 24/7/365 at the phone number printed on a customer’s Cigna ID card or at 1.800.244.6224. Customers can also find in-network hospitals and providers online using myCigna.com or the myCigna mobile app.
A spokesperson for ProMedica also provided this statement:
ProMedica has invested a lot of time, energy and effort into several months of negotiations with Cigna. We have worked diligently with Cigna to try to reach a renewed commercial insurance contract, but unfortunately, we were unable to come to a resolution. As a result, our commercial insurance contract with Cigna was terminated, effective today. That means many ProMedica providers and facilities are now out-of-network for Cigna members. ProMedica patients covered by Cigna who are seeking information on how this situation may affect them can visit www.promedica.org/cigna.
We empathize with our patients covered by Cigna insurance who just want to receive care from their ProMedica provider and have it covered in network. If Cigna had come to the negotiation table with reasonable and competitive terms that reflect the current realities of health care, we would not be in this situation. The fact of the matter is that health systems must have reasonable contracts with payors if they are to deliver high-quality care — reimbursements must cover our rising equipment, pharmaceutical, and staffing expenses.
ProMedica first notified patients about the pending contract termination with Cigna in February 2024 via mailed letters. We expect to continue to remind affected patients via office and registration site personnel and digital channels.
ProMedica remains open to continuing discussions with Cigna regarding a renewed contract, provided the insurance company demonstrates a sincere willingness to reach a fair agreement.
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