M Health Fairview and CentraCare may no longer be considered in-network for Humana's Medicare Advantage members beginning next year, according to the Star Tribune.
The change could affect more than 10,000 Humana members who receive care at M Health Fairview in Minneapolis, leaving them to pay higher out-of-pocket costs to access services at the health system. St. Cloud-based CentraCare did not say how many patients may be affected by the change.
A Humana spokesperson told the Star Tribune that the insurer is open to continuing negotiations with the health systems and is "disappointed this is occurring — particularly at this time, during the midst of the coronavirus pandemic and immediately preceding the start of [open enrollment]." Open enrollment for Medicare Advantage begins Oct. 15.
M Health Fairview told the publication its decision to split with the insurer is due to the "significant incremental cost of working with Humana to recover payments for services that we feel were denied inappropriately to Humana members. We hope our patients will consider a different Medicare Advantage plan that includes M Health Fairview as part of its network."
CentraCare told the Star Tribune that "effective Jan. 2, 2021, CentraCare will not be an in-network provider in the Humana Medicare Advantage program. We are currently in the process of informing our patients of their options, which are many."
Read more here.
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