Premier, Medical Mutual reach last-minute deal

Author: john willow

Author: john willow

Premier Health Partners and Medical Mutual of Ohio reached an eleventh-hour deal on Wednesday, Dec. 30, through which Premier will remain part of the health-care insurers network through June 30, 2013.

Medical Mutual in early November had announced it was terminating its agreement with Premier, effective Jan. 1, after failing to reconcile differences over reimbursement rates.

Medical Mutual spokesman Don Olson said there would be no interruption in network services for local members who use Premier facilities.

Medical Mutual in November had said about 1,000 Medical Mutual members used services in the past year at Premier hospitals, including Miami Valley and Good Samaritan hospitals and Atrium and Upper Valley medical centers.

But a permanent rift between Premier and Medical Mutual would have affected thousands of public-sector retirees. The Ohio Public Employees Retirement System has nearly 2,400 beneficiaries in the Dayton area that use the Premier hospital network, an OPERS spokeswoman has said. The majority are not Medicare-eligible, meaning theyre under 65 years old.

In 2010, a Medical Mutual plan also is the only option available for State Teachers Retirement System retirees 65 and older not enrolled in Medicare parts A and B, as well as for retirees under 65, an STRS spokeswoman has said. She couldnt say how many STRS beneficiaries would have been affected.

Medical Mutual also is the third-party administrator of Upper Valley Medical Centers self-insured health plan, though that hospital on Dec. 11 told employees the arrangement would continue for at least part of 2010. And the city of Springboro offers its workers insurance through Medical Mutual.

Had Medical Mutual dropped Premier from its network, it would have been the third private health care insurer to do so in the past five years. Premier and Anthem were separated for a year after a contract showdown in late 2004, but Premier rejoined the Anthem network in 2006. Humana dropped Premier from its network a year ago.

Negotiations are always complex, particularly in these challenging economic times, Premier told staff members in a memo Wednesday. We have appreciated your patience as we worked through this important process with Medical Mutual.About the Author:

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