The entrance to Peconic Bay Medical Center in Riverhead. (Credit: Barbaraellen Koch file)
Less than a week after PBMC Health publicly announced its plans to join North Shore-Long Island Jewish Health Center, the East End Health Alliance voted to begin the process of breaking down the three-hospital relationship formed seven years ago.
Alliance chair Patricia Stewart, a board member with Southampton Hospital, confirmed news of the agency’s decision on Thursday afternoon. (more…)
The contract between the three East End hospitals and Oxford/United Healthcare was renewed at midnight on Sept. 14, just as it was about to expire.
Roughly 3,000 local school employees insured through United Healthcare’s East End Health Plan had been without coverage at the hospitals since July 15. Another 12,000 Oxford/United participants were due to be out of network as of Sept. 15.
While Peconic Bay Medical Center and Eastern Long Island and Southampton hospitals were out of network, policyholders were eligible for emergency room and maternity care services there, but needed to go to in-network hospitals farther west for surgical and other services.
ELIH president and CEO Paul Conner said Thursday morning that the contract was signed “at the stroke of midnight, literally. We were a little anxious, but hopeful. At the end of the day it all came together. We’re happy to see that the East End Health Plan, which is administered by Oxford, is back in network, two months to the day after they went out.”
The three hospitals now negotiate with health insurance companies as a single entity, known as the East End Health Alliance (EEHA.) The group was formed, in part, to offer the facilities better leverage in dealing with larger insurance corporations.
Mr. Conner, the alliance’s spokesman, said details of the new contract will be made public later this afternoon. He added that there will be no major changes to the hospital coverage Oxford/United participants receive.
Although the contract between the East End’s three hospitals and Oxford/United Healthcare expired at midnight July 15, policyholders can continue to receive in-network services locally through Sept. 14.
That’s because the state requires the status quo to be maintained for a two-month “cooling off period” between the insurance company and Peconic Bay Medical Center, Eastern Long Island Hospital and Southampton Hospital, known collectively as the East End Health Alliance.
If a new contract isn’t secured by Sept. 15, the hospitals will continue to provide emergency services to those with Oxford coverage, but can provide non-emergency services only on an out-of-network basis.
Pregnant women insured by Oxford who were in their second or third trimester as of July 15 may be covered through postpartum care.
Talks that had broken off between the two sides resumed last week, but neither side is talking about the state of those negotiations.
Approximately 3,000 employees of several East End school districts are affected by the lack of a contract. If no deal is struck by Sept. 15, the impact will be felt by an additional 12,000 people covered by such plans as Oxford Liberty and Oxford Freedom.
Oxford/United Healthcare’s contract with the three East End hospitals expired this morning.
Eastern Long Island Hospital, Peconic Bay Medical Center and Southampton Hospital, which comprise the East End Health Alliance, will be out of network for people who have the East End Health Plan/United Healthcare and other locally, self-insured versions of the insurance company’s plans.
People who have Oxford Liberty, Oxford Freedom, and other fully insured United Healthcare plans will not be affected by the lack of a contract.
The East End Health Alliance said in a press release this week that the hospitals “are making every effort to ensure that ongoing negotiations are productive, and are hopeful a new contract will be reached prior to contract expiration.”
The hospitals are required by law to treat any emergency room patients who have the plans even if the contract is not in effect. Any tests and elective procedures that have received approval from United Health Care prior to July 15 will not be affected, and maternity care for pregnant women who have entered their second trimester will not be affected.
Times/Review Newsgroup will continue to cover the negotiations as new developments arise.