gchildress@heraldsun.com; 919.419.6645
Chapel Hill -- A dustup over fees between CIGNA Health Care and UNC Hospitals and Rex Hospital have Orange County officials crossing their fingers in the hope that the matter will be resolved before the New Year.
That's when the existing contract between the two healthcare providers and the insurer is scheduled to expire, forcing about 800 county employees to pay "out of network" charges to visit UNC, Rex or affiliated physicians.
"It's an especially big deal here in Orange County, home of UNC," said Diane Shepherd, benefits manager for Orange County. "We're optimistic that this will be resolved, but we don't have a crystal ball."
CIGNA of North Carolina has more than 25,000 customers throughout the state, many of whom are county employees insured through the County Health Plan owned by N.C. Association of County Commissioners.
Shepherd said the county has shared information about the controversy with employees to let them know that the insurance company and the health care providers are still negotiating the terms of the new contract.
UNC Hospitals spokeswoman Karen McCall said Thursday that all involved are working hard to resolve the conflict, which centers on the amount of payments for services.
"We certainly want to reach agreement as soon as possible," McCall said.
Meanwhile, in a letter to customers, CIGNA charged that UNC/REX Hospital-affiliated physicians want to be paid at a rate that is nearly twice the rate that Medicare has established as fair reimbursement in North Carolina.
"The fair rates offered by CIGNA would provide market competitive reimbursement for hospital and physician services," CIGNA officials wrote.
If UNC/REX do not relent on their demands, CIGNA officials say their clients will be forced to pass on the increased cost to their employees.
"The impact of UNC/REX's demand hits area businesses of all sizes, both public and private, in a time when companies are already constrained by the economic environment and struggling to stay open, keep jobs and offer health benefits," the letter read.
In a letter to patients, William L. Roper, CEO of UNC Health Care System, said UNC/Rex hospitals have only sought fairness during the past eight months of negotiations.
"In our discussions, we are asking CIGNA for fair and equitable payment that will pay rates similar to other Triangle medical centers," Roper wrote. "It costs just as much to provide care at UNC Hospitals and Rex Healthcare."
Roper urged patients to let CIGNA know how they feel.
"There is no reason for CIGNA to reject a fair contract, and there is no reason people should have to pay more to go to the hospital and doctor of their choice," Roper said.
