Nashville, Tenn., Mayor John Cooper sent letters to Vanderbilt University Medical Center and Humana officials urging the sides to prevent "what could otherwise unfold into catastrophic scenarios" if the health system splits with the insurer's Medicare Advantage plan.
The Nashville-based health system recently said it would go out of network with Humana's Medicare Advantage plans on April 1 if the sides are unable to agree on a new contract. The system said it would also go out of network with Centene subsidiary Wellcare of Tennessee's Medicare Advantage plans on the same date.
Mr. Cooper said in the Jan. 10 letter that all city government pensioners older than 65 are enrolled in Humana's Medicare Advantage plan. He said a split "could pose sudden, drastic and potentially harmful consequences" for its retirees, their dependents and others in the area who rely on Humana's plan for healthcare services.
The mayor is asking Vanderbilt and Humana to "continue mediated negotiations in good faith" to avoid disruption in services. Should those negotiations fail, the mayor is asking the parties to allow for continued services by Vanderbilt to all government Humana Medicare Advantage beneficiaries, "billing for such services as an out-of-network provider on a non-par basis."
Vanderbilt said it needs to be paid fairly for services it provides as it continues to tend with higher costs. Humana said it has attempted to negotiate, but the message it has received is that the system is "unwilling to discuss a new rate that is anything less than a 20 percent increase."