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ProMedica, Cigna Insurance contract termination possible April 1

If the contract ends, people covered by Cigna Insurance would be billed out-of-network costs at ProMedica facilities.

TOLEDO, Ohio —

ProMedica may soon end a contract with a health insurance company if the two parties don’t reach an agreement in negotiations over a new contract.

If Cigna Insurance and ProMedica are unable to reach an agreement, the contract will end on April 1. In a statement from ProMedica, the healthcare company says it entered a short-term agreement with Cigna in 2022.

The statement says ProMedica and Cigna have been negotiating for several months to reach a renewed contract, but have not come to an agreement.

This means patients will no longer receive in-network coverage at ProMedica facilities. If the contract is terminated on April 1, patients will be responsible for 100% of their billed charges at ProMedica out-of-network facilities, according to its website. The website also says patients can request an out-of-network waiver from Cigna for procedures they may schedule to receive.

Krissy Kisov is one of the people who will be impacted if the contract ends.

It’s going to be such a disruption of care,” Kisov said. “The continuity of care is not going to be there. People are in the middle of treatments. Chemo, radiation, myself — migraine treatments. It’s going to be an abrupt stop, and they have to find new providers in an area where it’s primarily ProMedica.”

Kisov said her family’s care will be impacted as well.

If I have to take my child to the ER, which I’ve had to do several times for his severe asthma, I’m going to be charged 100% I assume,” she said. “But they’re the children’s hospital in the area so that’s where I want to go. It’s really been super disruptive to our lives, and it hasn’t even happened yet.”

Kisov said they were informed about the decision in February.

ProMedica’s full statement reads:

In late 2022, ProMedica entered into a short-term agreement with Cigna in hopes of reaching a long-term agreement on rates and terms. ProMedica has been negotiating with Cigna in good faith for several months in an attempt to reach a renewed commercial insurance contract. Unfortunately, we have been unable to come to a resolution at this time, so a contract termination is possible on April 1. We understand that an insurance contract termination is incredibly frustrating for patients who just want to receive care from their provider of choice and have it covered by their insurance provider. However, we need Cigna to step up with a reasonable and competitive reimbursement offer that reflects the current realities of health care, including rising equipment, pharmaceutical and staffing expenses. Until then, we are forced to stand our ground in hopes of receiving a reimbursement offer from Cigna that will comprehensively cover the costs of delivering high-quality care. ProMedica patients covered by Cigna who are seeking information on how this situation may affect them can visit www.promedica.org/cigna.

Cigna has not yet responded to a request for comment.

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