United/Oxford Contract with East End Hospitals termed 7/15

This notice is from United Healthcare.  Typically, these things get resolved at the last minute (sound like something else we recently went through?) but you never know.  Stay Tuned… Reeve
East End Health Alliances Network Participation
In June, we sent you a notice regarding a potential contract termination with East End Health Alliance (EEHA). EEHA hospitals include Eastern Long Island Hospital in Greenport, NY; Peconic Bay Medical Center in Riverhead, NY; and Southampton Hospital in Southampton, NY.
 
Although we continue to negotiate a new agreement that is acceptable to both parties and meets our commitment to keep health care affordable, our current agreement with EEHA, which affects all commercial products (i.e., Oxford, UnitedHealthcare, Medicare and Medicaid), terminated on July 15, 2011.
 
Now that our contract with EEHA has terminated, the cooling off period mandated by the State of New York is in effect. The cooling off period provides an additional two months of access to the terminated facilities on an in-network basis to our fully insured commercial, Medicare and Medicaid members. The EEHA hospitals will remain in-network (participating) until September 15, 2011.
 
When speaking to your clients, please keep in mind the following points:
  • We will have Transitional Care guidelines in place so members who have scheduled or ongoing medical treatments at an EEHA hospital will continue to get care as appropriate.

  • Fully insured commercial, Medicare and Medicaid members will continue to have access to EEHA hospitals on an in-network basis through the New York State cooling off period, which will end September 15, 2011. Transitional Care may be available after the cooling off period in accordance with the members Certificate of Coverage.
  • After September 14, 2011, a primary care physician or specialist should not refer members to an EEHA hospital for any treatment or test. Instead, members should be referred to one of the major neighboring hospitals in our network, as listed below.
Neighboring Hospitals in Suffolk County
Brookhaven Memorial Hospital
John T. Mather Memorial Hospital
Saint Charles Hospital
Stony Brook University Medical Center
St. Catherine of Siena Medical Center
Southside Hospital

 
We are sending communications to your fully insured clients and members who may be affected by the EEHA termination from our networks. To view samples of these communications please click on the links below.
UnitedHealthcare Employer Letter
UnitedHealthcare Member Letter
Oxford Employer Letter
Oxford Member Letter
 
We will continue to work toward a positive outcome of affordable health care for our employers and their employees and will keep you informed about the status of the negotiations. If you would like more information or have questions, please contact your sales representative.