Aetna plans to end contract with Glens Falls Hospital, though negotiations continue [The Post-Star, Glens Falls, N.Y.]

Oct. 19--GLENS FALLS -- Aetna health insurance has notified local members it plans to end its contract with Glens Falls Hospital because of a rate dispute.

"Our contract with the hospital will end as of Nov. 16 unless we're able to reach a new agreement," said Susan Millerick, an Aetna spokeswoman.

Both the hospital and insurance company, however, said they are continuing to negotiate.

"We are continuing our discussions and negotiations with Aetna in the hope that we can reach an agreement on a new contract before November 16," said Darlene Raynsford, a hospital spokeswoman.

Raynsford said the hospital and Aetna have been negotiating since May 2011.

If a new contract is not reached, Aetna would remove Glens Falls Hospital from its network, which would mean members pay a substantially higher out-of-pocket cost if they choose to receive non-emergency care at the hospital.

"Saratoga (Hospital) is in network, and it's the closest facility. That's where we would encourage members to go for in network care," said Millerick, the Aetna spokeswoman.

Aetna insures 642 families in the Glens Falls region, which would be affected by the change.

The change would apply just to non-emergency hospital care.

Health centers affiliated with the hospital would remain in the Aetna network, and Aetna covers all emergency care on an in-network basis, Millerick said.

Neither the hospital or Aetna would discuss specifics of the dispute.

They (the hospital) feel that they need a reasonably substantial increase," Millerick said. "Our feeling is that one of the primary responsibilities we have to members and our employers ... is that we have to work to try to control the rising cost of health care."

Raynsford said the hospital wants "rates that are reasonable and competitive with those of other commercial insurers."

Aetna recently wrote its members that it intended to end its contract with the hospital.

"Under state law we're required to provide notice to members in a prescribed amount of time in advance of a termination like this so they can make other health care arrangements if they need to," Millerick said. "So it's just following the letter and the spirit of the law to let people know that it's looking like we're not going to reach an agreement."

Negotiations had broken off when Aetna sent the letter out, but the two side have since resumed negotiations, she said.

"We remain open to some more good faith negotiations and hope to reach an agreement, because certainly we'd like to have the hospital remain in our network," she said.

Raynsford said the hospital is involved in routine negotiations with one other health insurance company, but those negotiations are going smoothly.

The hospital is not the only local health care provider Aetna has had disputes with.

In August 2011, Hudson Headwaters Health Network, which operates health centers in five area counties, ended its contract with Aetna, after two side were unable to resolve a rate dispute.

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