Highmark informed Aetna in July that the Jefferson Hospital provider contract would not be renewed after Dec. 31. However, Aetna claims the termination is in violation of specifications provided by Pennsylvania’s Insurance Department when Highmark acquired West Penn Allegheny Health System in 2013. Specifically, Aetna claims the contract termination is a year sooner than allowed, according to the report.
If Highmark is allowed to rescind the contract as of Dec. 31, Aetna will have to pay out-of-network costs to use Jefferson Hospital, even though “numerous” Aetna members already purchased health insurance plans based on the belief they would have in-network access to the hospital through the end of 2015, according to the report.
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