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Humana Contract Negotiations Update as of 2/8/18

Hospital news | Thursday, February 8, 2018

Clark Fork Valley Hospital has been engaged in contract negotiations with Humana in the effort to participate in their Medicare Advantage product since October, 2017 when we learned that Blue Cross/Blue Shield would no longer be serving our community with a Medicare plan. Much of the effort to negotiate contract terms was delegated by CFVH to our Physician Hospital Organization, Monida Healthcare Network, who is working on our behalf.

In early January, we informed Humana and Monida that we would be making a final decision regarding contract participation and announcing that decision to our local communities by February 1, stressing the urgency of completing the contract negotiation by that date. As of January 31, we believed that there was positive movement in the discussions and that Humana would require another week to obtain approval of the contract terms from their legal department. We began communicating to CFVH staff and patients at that time that we were very confident we would have a contract in place, retroactive to January 1, but would not know for sure until February 7.

On February 7, we were informed by Humana that they did not yet have approval for the contract from their legal department, and they could not provide a date when that approval would be received, despite the fact that they knew we had made a commitment to our community. Given that, the best we can do today is assure our Medicare patients that once we are provided a contract consistent with the agreements we have come to with Humana’s representative, CFVH will sign it. It is our expectation that the contract will be effective January 1, 2018. We understand how unsettling this situation is for individuals who were sold Humana coverage while there were no participating providers in their local community. We apologize for the ongoing uncertainty, but must reiterate that the ball is in Humana’s court at this point, and they have not provided us with a timely response as expected. We will continue to keep the public apprised of the developments related to this issue.

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