AAMC, Aetna resolve contract dispute ; Insurance tussle created uncertainty for patients [Capital (Annapolis, MD)]

A dispute that threatened to sever ties between a major insurance carrier and the area's most popular hospital has been resolved.

More than 5,700 patients had been warned they would be cut off from doctors at Anne Arundel Medical Center because of a contract dispute with Aetna.

AAMC and Aetna officials said the dispute, which focused on how much doctors employed by the hospital would be reimbursed, was resolved yesterday afternoon. A new four-year contract could be signed as early as next week.

It brings peace of mind to patients and doctors alike who worried an end to the relationship would have major repercussions.

Since November, Friendship resident Lori Rose has received four letters from medical providers warning her that come January, the hospital where she gave birth to her daughter 32 years ago would no longer accept her insurance. Her husband, a cardiac patient, would have to pay the full tab or go elsewhere.

"Here's one of the top hospitals in the country in our own backyard, and I can't use it?" Rose said.

In other cases, soon-to-be moms had switched plans. A cardiac patient feared what would happen if disaster struck and he could go to AAMC. One four-doctor Severna Park practice urged patients to lobby the insurance company or find a way to switch plans.

"Sadly, we will not be able to accept your insurance if you stay with Aetna," the doctors wrote on Facebook. "So, PLEASE, look into alternative health care plans."

Aetna insures more than 580,000 people in Maryland, including hundreds of state workers. The state government warned employees that the dispute could affect 257 physicians who have exclusive admitting privileges to AAMC, including 93 primary care physicians and 164 specialists.

Though Aetna informed their patients that the dispute meant AAMC could be off-limits for insurance coverage, an official said yesterday it's not the company's policy to let patients know the conflict has been resolved.

"We were about to reach the point that we were going to start rescheduling major surgeries at other facilities," Walt Cherniak, spokesman for Aetna, said.

"Aetna has a dual obligation to our beneficiaries," Cherniak said. "On the one hand, we work to provide them with access to a broad access to health care service, but on the other hand, it's our job to help control the rising cost of health care."

Dr. Mitchell Schwartz, chief medical officer for Anne Arundel Health System, said the hospital "reached out" to Aetna to renegotiate on behalf of doctors. He declined to explain how severing ties with Aetna would have impacted patients, had talks not been resolved this week.

"We're happy to have put this behind this, and I'm sure that Aetna is as well," he said.

But fallout from the dispute may linger.

At Special Beginnings Birth & Women's Center in Arnold, some expectant mothers already have made the switch.

"We have patients who are going away from Aetna. They don't want to have the risk having their hospital bill not paid," the center's director, Ann Sober, said. "That could be crippling for a young couple."

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