More than 30,000 Texas patients may be affected by an ongoing health care dispute.
Unified Women’s Healthcare of Texas says the health care insurer Aetna just terminated their existing agreement with the group.
That means if the two sides aren’t able to reach a new deal by August 15, patients who are insured by Aetna and go to any of the more than 160 Unified Women’s Healthcare providers in Texas will be out of network.
According to its website, Unified Women’s Healthcare of Texas is the largest group of OB-GYNs in the nation.
Shirley Sturgis is angry. Her gynecologist is one of the providers that may soon be out of network. She’s been going to Dr. Patrick Allen for years.
“I’m 65 and all of a sudden I’m told that, ‘Oh, you are no longer going to be able to see the doctor that I have been seeing for several years,'” Sturgis said. “And now I’m supposed to go see another doctor, someone that knows nothing about me.”
Unified Women’s Healthcare released a statement Thursday.
“Unified Women’s Healthcare of Texas will continue to exercise all administrative remedies available to our Ob-Gyn group to remain in network with Aetna. We have formally appealed Aetna’s decision, and we also have submitted a complaint to the Texas Department of Insurance,” Unified Women’s Health Care of Texas said. “More than 30,000 patients are affected by Aetna’s decision to terminate this agreement. We are doing everything possible to provide our Aetna patients with continuity of care and to minimize any disruption that affects their care.”
Aetna also released a statement to WFAA.
“We remain in active negotiations with Unified Women’s Healthcare and we hope to reach a new contract with the provider group prior to the termination date of August 15th,” a spokesperson for Aetna said.
“Aetna has a dual responsibility to our customers. The first is to provide our members with access to comprehensive health benefits coverage that is both accessible and affordable. The second is to help contain rising health care costs, which threaten our plan sponsors’ abilities to continue providing coverage for their employees,” the spokesperson said. “If Aetna’s contract with Unified Women’s Healthcare terminates on August 15th, our members will be able to receive care from other providers in our network.”
Sturgis hopes this issue will be resolved. She says going to the gynecologist is a deeply personal experience and it’s not easy to simply pick up and find a new provider.
“I don’t want to go where they want me to go. I want to go where I want to go. I want to be up under the person that I know gives good care,” Sturgis said.