Covered by Cigna? Insurer could split from Memorial Hermann

HOUSTON, Texas (KTRK) -- Memorial Hermann Hospital patients who are covered by Cigna are caught in the middle of a rate negotiation battle between the two health giants.

Cigna said its contract with the hospital will end March 16, 2020, if the hospital and insurance company can't reach an agreement.

"I think that's going to be a bad thing, and they're going to hurt a lot of people," said Houston resident Easton Charles.

According to Cigna, 178,000 people could be affected by this.

"Somebody's being greedy," observed Houston resident Darla Wheatfall. "Either the insurance company or the hospital, but somebody's being greedy."

Cigna said Memorial Hermann has raised its prices and has refused to engage in "meaningful negotiations with Cigna that would bring rates for Cigna customers in line with what the hospital system charges other customers."

Memorial Hermann sent ABC13 this statement:

"Memorial Hermann is committed to serving the needs and best interests of our community. Advocating for our patients' health, from access to resources to lower costs of care, requires support and engagement from many stakeholders-hospitals, employers, insurance companies and more. Unfortunately, Cigna has been unwilling to meaningfully engage with Memorial Hermann in the creation of value-based programs as an effort to collectively lower costs for patients across our service area. While it is unfortunate that we have been unable to find common ground in this longstanding partnership to provide Houston employers and customers with competitive plans and rates, as always, we remain committed to maintain a cost of care that is line with the market and our community. Our goal is to make Houston a healthier place to live today and for generations to come. We remain open and ready to work with willing partners in this effort."

"The truth usually is, it takes both sides to form a contract, and either side could give a little bit, and that doesn't seem like it's happened here," said University of Houston insurance law professor Seth Chandler. "It's becoming more prevalent. We have greater concentrations of hospitals, and we have greater concentrations of insurers, and when that happens, you get a game of chicken. And in this instance, neither side swerved."

He said battles like this only hurt the patients caught in the middle.

Experts add it's best to start looking for a new hospital now, and also be sure to get all of your medical records from your doctor.

"Customers receiving ongoing care for certain conditions may be able to continue their care at Memorial Hermann at the in-network benefit level for a set period of time under their plan's continuity of care guidelines," Cigna said. "Cigna's action does not affect its Medicare Advantage plans."

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