Aetna-Piedmont dispute

Patients face coverage deadline

by Clay Neely - clay@newnan.com

A contract dispute between Piedmont Healthcare and Aetna/Coventry insurance might leave Coweta County area policyholders searching for an alternative to their current physicians and hospitals by Feb. 1 if a resolution is not reached.

Last week, local customers of Aetna/Coventry received a letter in the mail from Gregory Hurst, CEO of Piedmont Healthcare, explaining that the two companies have been in negotiations over a contract dispute that is currently set to expire on Jan. 31.

According to Hurst, the agreement would include not only Piedmont Fayette Hospital and Piedmont Newnan Hospital, but also more than 1,000 physicians who make up the Piedmont Physicians Group, Piedmont Heart Institute Physicians and Piedmont Clinic.

“We are optimistic about completing negotiations and reaching agreement within the next few weeks,” said Hurst in a press release. “However, if the contract expires, Aetna/Coventry will be forcing HMO members to find new doctors, and both HMO and PPO patients with Aetna/Coventry may incur higher out-of-pocket costs for care they receive at Piedmont hospitals and with Piedmont physicians as out-of-network providers, beginning February 1.”

“While there is no cause for great alarm at the time, it is important that you have the facts,” continued Hurst. “We are working diligently to renegotiate this contract on behalf of our five hospitals and physicians without creating undue anxiety or worry for our patients.”

According to Aetna/Coventry public relations spokesman for the Southeast U.S., Walt Cherniak, there is no cause for alarm.

“Because Aetna purchased Coventry in 2013, what we have here with Piedmont is both an Aetna contract with Piedmont and a Coventry contract,” said Cherniak. “Because those deals are both set to expire at the end of the month and we have not yet signed a new contract, we kicked off notification requirements which state that within 30 days of an expiration of a contract, we are required to notify people about the possibility of the termination.”

“We’re actively involved in negotiations with Piedmont and we are very hopeful we will reach resolution on a contract by Jan. 31 and avoid any disruption for members who use those facilities. We have a long standing contractual obligation with Piedmont and we hope to continue it,” said Cherniak.

Cherniak said that Aetna/Coventry covers more than 600,000 Georgians and currently has contracts with all or nearly all the hospitals in metro Atlanta but was unable to provide detailed numbers for their Coweta County members. Both Piedmont and Aetna have fought high-profile contract battles in the past. In 2011, Piedmont and Aetna reached a last minute deal for their current three-year contract which is set to expire at the end of this month.



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