Some local school workers no longer covered at East End hospitals

07/19/2011 6:44 AM |

The roughly 3,000 participants in the East End Health Plan, many of whom are employees in local schools, no longer qualify for treatment at the three East End hospitals.

As of midnight last Friday, the three hospitals that form the East End Health Alliance — Eastern Long Island Hospital in Greenport, Peconic Bay Medical Center in Riverhead and Southampton Hospital in Southampton — are no longer in network for participants in the plan, which is partially underwritten by Oxford/United Healthcare.

ELIH President and CEO Paul Connor said Monday that he and the other hospitals are anxious to get back to the bargaining table to bring the hospitals back in network for East End Health Plan’s subscribers.

“We want to work with Oxford to minimize the out of network period. We would like to get back to the table,” he said. “We’ve been trading correspondence and we’ll be reaching out to them this week to try to re-engage.”

Representatives from East End Health Plan were not immediately available for comment.

According to the health plan’s website, employees of the Greenport, Southold, Oysterponds and Shelter Island school districts are covered through the plan, along with several school districts on the South Fork.

Though the local hospitals will not be able to offer elective treatment to the plan’s subscribers while they are out of network, Emergency Room services and admittance through the Emergency Room will continue to be provided, as is required by law.

Surgery that was authorized prior to July 15 and maternity treatment for pregnant women in or beyond their second trimester is also still covered.

Mr. Connor said that while he hopes a deal with Oxford/United Health care can be reached for the East End Health Plan participants, another 12,000 enrollees in Oxford’s fully insured plans may also face going out of network if the insurance company doesn’t reach a deal with the hospitals within 60 days of July 15.

byoung@timesreview.com