September 29, 2015

 

Lutheran Medical Center located in Brooklyn, NY will terminate from our Metro New York Aetna network effective November 01, 2015

 

Highlights

 

  • Lutheran Medical Center’s contract with Aetna is due to expire Nov. 1, 2015.
  • Lutheran sent a termination letter to Aetna in March 2015. We have engaged the hospital in negotiations several times since then, but we have not been able to reach an agreement over rates
  • NYU, which acquired Lutheran recently, is insisting on unreasonable increases that we cannot accept.
  • While we remain open to further discussions, at this point, it appears likely that Lutheran will leave the Aetna network following the termination date and the state-mandated cooling-off period.
  • Aetna has a dual responsibility to its members in New York. We aim to provide broad access to quality hospitals and physicians, but we also are charged with containing the rising costs of health care.
  • The New York State 2-month Cooling Off period applies to members in fully insured commercial plans. For these members, the hospital will be out-of-network effective January 1, 2016.
    • Letters to impacted members of Medicare and self-insured plans will be mailed on 9/24/2015.
    • Letters to impacted members of fully-insured commercial plans will be mailed on 11/13/2015.
    • If an agreement is reached after these notices have been mailed, retraction letters will be sent to all members who received the initial notification.

 

Hospital Locations

Lutheran Medical Center

150 55th Street

Brooklyn NY, 11220
There are 259 participating physicians who have exclusive admitting privileges to Lutheran Medical Center. These physicians will terminate from the network on 01/01/2016. A listing of these providers and disruption will be provided closer to the termination date.