Tower Health has announced that it will no longer accept Cigna insurance plans starting next year.
The cutoff includes all Cigna plans and applies to all Tower Health locations and physicians. It will go into effect Jan. 1.
It is not immediately clear how many patients will be impacted by the decision.
According to Tower Health officials, the health network was asking the insurance provider to increase its payment rates as part of negotiations to renew a provider agreement set to end Dec. 31.
“Tower Health, like other health systems, has been contending with unprecedented cost increases for personnel, supplies, equipment and medication necessary to continue providing high quality care,” a statement from Tower Health reads. “Cigna has been unwilling to compensate Tower Health at reasonable payment rates.”
Tower Health officials said Cigna’s refusal to increase payment rates comes as the insurance company outperformed its third quarter market forecasts, earning profits of $1.4 billion.
“Your well-being is Tower Health’s top priority, and we cannot continue to participate with a health plan under terms that don’t uphold the high standard of care you expect and deserve,” a message sent to Tower Health patients read.
Officials from Cigna said Tower Health’s request for higher payment rates would have meant higher costs for patients.
“We are disappointed that Tower Health is choosing to leave our network Jan. 1 unless we agree to their demands for significant rate increases that will make health care much more expensive for the people we serve,” a statement issued by Cigna read.
The Cigna statement said the company’s goal is to keep health care affordable for its clients and customers, particularly as they deal with the lingering impacts of inflation.
“It’s important to understand who pays the bills: any increase in cost of care is paid directly by local employers, their employees and families,” the statement read.
The Cigna statement said the company is continuing to negotiate in good faith with Tower Health in an attempt to avoid a disruption for customers, adding that Cigna has proposed a contract extension.
It does not appear Tower Health is prepared to accept that proposal, however. The health network has already begun contacting patients with Cigna insurance to inform them that, as of the start of the new year, their insurance plans will no longer be accepted.
What does it mean for patients?
Tower Health’s decision will impact all Cigna insurance plans.
In the notices sent to patients, the health network says all Cigna members will no longer be able to receive non-emergency care from Towner Health providers at their plan’s maximum benefit level. That includes commercial plans through an employer, Medicare Advantage plans and behavioral health plans.
Members of a Cigna preferred provider organization (PPO) plan that provides out-of-network benefits will be able to access Tower Health providers, however their out-of-pocket costs will be higher than would otherwise apply.
For patients currently undergoing treatment with a Tower Health provider, the health network said it will work to make sure there are no interruptions in treatment. The message to patients said those patients will be able to continue to see their Tower Health provider at no additional cost until care can be safely transitioned to a Cigna participating provider.
“If necessary, your Tower Health provider will work with you and Cigna to ensure that your care is transitioned appropriately,” the message said.
Cigna officials also have said they are willing and able to help patients transfer their treatment from Tower Health to another provider.
The company has a 24-hour customer service hotline at 1-800-244-6224. Customers can also find in-network hospitals and other providers online at myCigna.com or through the myCigna mobile app.
Source: Berkshire mont