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| ProviderLAW Advisory | |||||
The Latest on the Aetna-ASHN Front | |||||
Aetna Notifies a Provider of Its Intent to "Terminate the Provider Agreement With ALL Aetna Products" Due to His Decision Not to Join ASHN with Respect to a Few Products. | |||||
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A copy of this Advisory |
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Here is the latest development on the Aetna-ASHN front. As many of you will recall, several months ago, Aetna announced that it would be forming a managed care contract with an organization known as American Specialty Health Networks (ASHN). The contract apparently involved certain Aetna products, but not all. A subscriber recently received a letter from Aetna when the company learned that the subscriber had declined to sign up with ASHN. The letter explained: |
"[S]ince you have not applied for participation in the ASH network, we must notify you of our intent to designate you as nonparticipating in Aetna HMO-based commercial and Medicare Advantage plans effective [ an upcoming date ], and terminate the Provider Agreement for all Aetna products between [ you ] and Aetna... This termination will be effective on [ the termination date of your agreement ], as per your agreement. ...If you wish to continue seeing Aetna members, please contact an ASH representative at [ phone number ]." (emphasis added) |
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Before addressing the letter, we would remind all readers that if you have any questions of a legal nature, you should contact an attorney at law. With that being said, the letter would appear to raise a number of questions. What would prompt Aetna to send out a letter like this, or to get involved like this? How many other providers have received a similar letter? If the Aetna letter fails to prompt significant numbers of providers to join ASHN, how many provider agreements will Aetna in fact terminate? Will Aetna act on its intent? To what extent? Subscribers are encouraged to really look at this situation, ask themselves hard questions, and also speak with an attorney as they formulate their answers. Obviously, if we can be of any assistance, please feel free to call. |
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