Update: Health Net and Tenet reach agreement

Health Net and Tenet Healthcare Reach New Agreement January 31, 2013 Press Release
At Health Net, we work hard to provide affordable coverage options for our customers – and maintaining sustainable network contracts is a critical part of that work. 

We informed you earlier this month that we were unable to reach agreement on terms with Tenet Healthcare, and therefore had to unfortunately end our relationship with all six of its Southern California facilities.

We are pleased to inform you that shortly thereafter, we entered back into discussions with Tenet Healthcare, and we reached a new multi-year agreement with all 11 Tenet Healthcare hospitals in California. In addition to covering Tenet Healthcare’s 11 facilities statewide, the new two year agreements reinstate and retroactively cover Tenet Healthcare’s six Southern California hospitals that were terminated from Health Net’s network on December 22, 2012, as if there was no termination.

I guess the Tenet blinked and Health Net came out on top: the power of a press release.

Original Post below

Health Net of California announce on January 11th that because they were unable to reach agreement on reimbursement costs, specific Tenet Hospitals will no longer be a part of their network of service providers for certain Medicare, Medi-Cal and commercial health insurance plans.

Without knowing the details of the previous agreement, it is hard to speculate about which terms led to Health Net dropping some Tenet facilities as a network provider. Although, both Medicare and Medi-Cal have been under intense pressure to reduce costs which means clamping down on reimbursements for certain procedures and tighter over sight.

Health Net Statement:

Tenet Healthcare Systems – Provider Contract Update

At Health Net, we work hard to provide affordable coverage options for our customers – and maintaining sustainable network contracts is a critical part of that work.

We want to inform you that while we tried to negotiate an agreement with Tenet Healthcare, unfortunately we were unable to reach agreement on terms, and therefore our contract with six of the Tenet hospitals in Southern California terminated effective December 21, 2012. This impacts Health Net plans for Medicare, Commercial, and State Health Programs, and involves the following Tenet Healthcare hospitals:

• DESERT REGIONAL MEDICAL CENTER
• JOHN F. KENNEDY MEMORIAL HOSPITAL
• FOUNTAIN VALLEY REGIONAL HOSPITAL & MEDICAL CENTER
• LAKEWOOD REGIONAL MEDICAL CENTER
• LOS ALAMITOS MEDICAL CENTER
• PLACENTIA LINDA HOSPITAL

The hospitals are contracted for the following Health Net plans:

• Commercial HMO, PPO, POS
• State Health Programs: Healthy Families, Medi-Cal, CalOptima
• All Medicare plans, including Dual Risk with Leisure World

Member impact
Rest assured, this change will not compromise members’ benefits or interrupt their access to quality care.

• Elective services will need to be received at another hospital in the Health Net network.
• Commercial Members with open authorizations have been mailed notification letters and Transition of Care forms.
• As required by our regulators, Medicare, Medi-Cal and Healthy Families members with open authorizations have been mailed notification letters.
• Members will not have to change their primary care physician.
• We have identified alternative hospitals that members may access in our network. We are confident that these hospitals will provide the full range of services our members may require.

Alternate Participating Hospitals for Each Terminated Tenet Facility

We appreciate your partnership and your support as we continue to try to address the rising costs of health services for our employer groups and members alike. If you have any questions, please contact your Health Net sales representative.