Humana letters leave CEO blindsided
CHARLESTON, W.Va. - Call it the power of word processing: two letters set off a chain of events last month that still has thousands of state Medicare recipients shaken up, hospital administrators scratching their heads and West Virginia lawmakers fighting mad.
On Dec. 5, Thomas Health System president and CEO Steve Dexter received a letter from the Medicare Advantage provider Humana.
The one-page letter said Humana would terminate its contract with St. Francis Hospital effective Feb. 1, 2012.
"The dynamics in the Charleston area have changed and the ChoiceCare Network is reconfiguring its network," read the opening sentence.
One day later, an identical letter arrived at Thomas Memorial Hospital in South Charleston. The letters, signed by director of contracting Beverly Steen, quoted part of Humana's agreement with the hospitals:
"Either party may terminate this agreement without cause at any time . . . by providing to the other party 90 days prior written notice of termination."
Dexter said the correspondence came "totally out of the blue." It was such a surprise that the CEO didn't think the letters were genuine.
He called Humana, and representatives told him not to worry. They said the company was canceling all of its contracts and drafting new ones.
Dexter received that new contract a week later and found it did not include any personal coverage for Humana Medicare patients.
Again, the CEO was blindsided.
Between 2009 and 2011, about 3,600 of the hospitals' patients received health coverage through Humana.
Thomas Health Systems' contract with the company was set to expire Jan 31, 2012. Hospital officials figured if Humana were to terminate its contract, they would have received word in late October or early November.
"We wrote back and said, 'Do the math,' " Dexter said. "You gave us 56 days notice.
Humana Choicecare Health Insurance - News
Dexter received that new contract a week later and found it did not include any personal coverage for Humana Medicare patients. Between 2009 and 2011, about 3600 of the hospitals' patients received health coverage through Humana. Thomas Health Systems'
"As such, Thomas Health System will remain in network as a ChoiceCare contracted provider." Humana's initial decision to drop Thomas and St. Francis caused a flurry of confusion and criticism from patients, state officials and West Virginia's
6, a day before the deadline for members to enroll for coverage. In a Nov. 26 letter to Dexter, Beverly Steen, Humana's director of contracting, wrote: "Your ChoiceCare Network agreement is terminated without cause effective 2/1/2012 for all lines of
Steen's letter provided no detailed explanation about why Humana was withdrawing from its contracts with the Thomas Health System. "The dynamics in the Charleston area have changed and the ChoiceCare network is reconfiguring its network," Steen wrote.
When those children get sick, their mothers and fathers without paid sick days are forced to make a choice: care for their families or provide for their families. Low-income parents are particularly affected, as fully 80 percent of low-wage jobs do not
Letters, Jan. 24, 2012 - Letters - The Charleston Gazette - West ...
Tyler Mountain helping neighbors
Editor:
As executive director of Tyler Mountain/Cross Lanes Community Services, I am writing to report on an eventful 2011! TMCLCS is a nonprofit social service agency dedicated to helping local residents with their basic needs. We provide families and seniors with food, utility and rental assistance as well as help with transportation and clothing. In addition to our year round services, we also operate a volunteer-driven Thanksgiving Dinner and Christmas Basket Program.
Due to elevated utility and food costs, Tyler Mountain/Cross Lanes Community Services has expanded its food pantry and increased office hours. Our food program now serves more than 350 individuals each month with a grocery voucher in addition to canned food and perishables from our pantry. In response to the hunger crisis in our community, TMCLCS enlisted individuals and local businesses to participate in our "Pantry Partner Program" that allows donors to 1) contribute funds to cover our pantry costs for one month and/or 2) collect canned food for one month to supplement other donations. So far we have received terrific support from our neighbors and we'd like to formally thank those "Pantry Partners" who have contributed thus far: Psychological Consultation and Assessment, J.F. and Linda Lacaria, Lake Chaweva Club, Ann and Steve Warnick, Scratch and Dent Appliances, Cross Lanes Veterinary, T&M Meats, Cadle Sanitary Services, CDI, Anytime Fitness, Employer's Innovative Network, All Med, Tyler Mountain Volunteer Fire Department, Ernest and Alma Page, and Keller Funeral Home.
Our agency would not be possible without the many donors and volunteers who participate in providing basic needs assistance to our community. Anyone interested in becoming a "Pantry Partner" or a donor for other TMCLCS services, may contact us at (304) 776-5813 or visit our website at tmclcs.org . Thank you to everyone who supports our efforts to assist our most vulnerable neighbors: children, seniors, the disabled, and the working poor.