Update: Responses from Boca Regional and Humana, at bottom.
Thanks to a reader tip we’ve heard that health insurer Humana may be removing Boca Raton Regional Hospital from its network of providers, effective October 1st. Humana now tells us (see bottom) that the change was initiated by Boca Regional. That was not clearly conveyed in their letter, and the “he hit me first” argument is not terribly important.
Here’s the letter from Humana that our reader sent to us (click on image to see larger version):
We’ve seen this before with Humana. When we initially looked at the “Obamacare” plans, Humana had the cheapest options we saw and the provider networks were very limited. We mentioned this to the reader who said this was not an Obamacare or HMO plan, but rather a PPO.
Humana was also featured in an article last year for “shaving networks.”
Earlier this year we covered a similar situation involving Cigna and West Boca Medical Center. That was resolved before the coverage was dropped.
According to the letter Humana customers will still have West Boca Medical Center and Delray Medical Center in the network along with several others. The letter does not mention Broward Health facilities such as Northwest Medical Center in Margate.
Boca Regional Hospital responded quickly with the following statement from Thomas Chakurda, their VP of Marketing:
Boca Raton Regional Hospital is presently negotiating in good faith with Humana on our contract, which expires October 1st, 2014. We are hopeful that these discussions will result in a mutually acceptable agreement and one that affords us rates that are comparable to other providers in the region. In situations like this, it is a normal occurrence for both a provider and a payor to alert their respective constituencies of the possibility that a contract may not be renewed.
Humana also responded via an e-mail from Mitch Lubitz, media relations:
Boca Raton Regional Hospital has informed Humana that it is terminating the existing Medicare and commercial network agreement with Humana effective October 1st. This contract termination was initiated by Boca Regional, not Humana. We remain ready to negotiate an agreement with Boca Regional at terms that are beneficial to both parties. In the meantime we have informed our affected health plan members of the pending network change and provided then with information about alternative hospitals and providers in Palm Beach County, ahead of the Medicare annual election period which begins October 15. Hope that is helpful to you and West Boca News readers. Thank you.
We should note that our reader specifically told us she is not in a Medicare plan.
