Negotiations between the parties began in December 2019, when Mednax subsidiaries Pediatrix Medical Group and Obstetrix Medical Group requested to renegotiate reimbursement rates, the Dallas Morning News reported.
Pediatrix and Obstetrix President Roger Hinson, MD, said the reimbursement cuts Aetna had proposed were not sustainable.
“A draconian cut in your rate is not a negotiation,” Dr. Hinson told the publication.
Aetna Vice President Richard Gentleman told the Dallas Morning News that Mednax had requested a 22 percent reimbursement increase during the first round of negotiations. “That roughly equated to about $11 million for our Texas Health Plan. And also they were demanding another one and a half million dollars in other payments to them,” he said.
Further negotiations in 2020 failed to yield a contract renewal.
Texas Mednax providers will become out of network for the state’s Aetna patients as early as July 1 without an agreement.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.