HealthNet Eliminates Sutter Health from Medicare+Choice ‘Giant’
Woodland Hills-based HealthNet has announced that as of Jan. 1, it no longer will pay for its 25,000 beneficiaries in Seniority Plus, a Medicare+Choice plan, to receive care from health system "giant" Sutter Health, the San Jose Mercury News reports. HealthNet spokesperson Lisa Kalustian said that because HealthNet has not yet negotiated a new contract with Sutter for non-Medicare beneficiaries, the insurer decided to announce the decision to drop Sutter from its Seniority Plus plan early to allow seniors to change insurers, if necessary, or "organize transition plans" for patients undergoing treatments such as chemotherapy. HealthNet's decision "is based on the necessity to keep health care affordable," Kalustian added. She said, "If we had been able to reach an agreement with Sutter that was adequate and reasonable, this decision may have been different." Sutter spokesperson Bill Gleeson said that HealthNet's decision "disappointed" Sutter, adding that it "does cause some concern going forward" with other HealthNet contract negotiations. Seniors not in Seniority Plus will not be affected by the move. But those Northern California seniors who are beneficiaries in HealthNet's Seniority Plus will have to switch doctors or purchase a more expensive HealthNet plan or change insurance companies altogether if they want to remain with their current doctor (Feder, San Jose Mercury News, 8/28).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.