Amid insurance fight, some California hospital staff lose health coverage at their own facilities

More than two weeks after Clovis, Calif.-based Community Health System went out of network with several major insurers, hospital staff members are speaking out after being left without covered access to the system's facilities.

On Dec. 31, in-network contracts expired between Community and several commercial payers, including UnitedHealthcare, Cigna and Anthem Blue Cross. The involved parties are still actively negotiating to reach agreements.

Amy Evans, MD, is a pediatrician at Clovis Community Medical Center and Community Regional Medical Center in Fresno, Calif., and is insured by one of the affected health plans, according to KFSN.

"What's ironic is that we are working downtown and working at Clovis and other hospitals, and we actually don't have access to get our own personal medical care at those hospitals," she told the news station. "I think it's a slap in the face to the doctors who actually work in the hospitals to not be able to go to the places where we work."

The coverage issues come as the Fresno region faces a major healthcare access challenge.

Nearby Madera (Calif.) Community Hospital, the city's only hospital serving about 160,000 residents in the county, began closing on Dec. 30, prompting an emergency declaration from Madera County officials over a lack of services. By Jan. 10, closures included three affiliated clinics in Madera, Mendota and Chowchilla (Calif.).

In response, neighboring Fresno County declared its own emergency on Jan. 3, citing the additional strain the Madera hospital's closure has put on other area hospitals.

Community Regional Medical Center in downtown Fresno is one hospital bearing the brunt. Danielle Campagne, MD, head of emergency department care at Community Regional, said the facility is already "blowing up" with patients, with dozens being cared for in hallways, KVPR reported Jan. 5.

"We're in dire straits. Patients are struggling and it's really hard," she told the news station. "Madera … is going to be the tipping point for us."  

Congressman Jim Costa (D) and Congressman John Duarte (R) wrote a letter to HHS Jan. 6 requesting that a local health emergency be declared in Madera County.

On Jan. 10, the Madera County board of supervisors met to weigh options on how to save the city's hospital, including using federal pandemic funds and hiring an outside consultant. 

State lawmakers have also called on Trinity Health to renegotiate a failed acquisition of Madera Community, KVPR reported Jan. 13. Trinity's plan to buy the hospital fell through because the health system didn't accept the conditions set forth by California Attorney General Rob Bonta.


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