{"id":122340,"date":"2026-01-06T17:07:08","date_gmt":"2026-01-06T17:07:08","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/122340\/"},"modified":"2026-01-06T17:07:08","modified_gmt":"2026-01-06T17:07:08","slug":"about-1500-retired-fresno-unified-workers-lose-access-to-crmc","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/122340\/","title":{"rendered":"About 1,500 retired Fresno Unified workers lose access to CRMC"},"content":{"rendered":"

\t\t\t\t\tWhat’s at stake?<\/p>\n

Fresno Unified could drop the lapsed insurance contract, but officials say the process would take months.<\/p>\n

Roughly 1,500 retirees on Medicaid who receive medical coverage from Fresno Unified have lost access to Community Medical Centers following unresolved negotiations.<\/p>\n

In the last board meeting<\/a> of 2025, the Fresno Unified Board of Education approved a contract with insurance company Aetna to maintain healthcare coverage for around 6,200 retirees and dependents.<\/p>\n

However, at the time of the board meeting, contract negotiations between Aetna and Community were still ongoing despite a deadline of Dec. 31. Around 1,500 retirees and dependents see a primary care doctor at Community.<\/p>\n

But with that deadline now passed Community facilities are no longer considered \u201cin-network\u201d, leaving many retirees with only emergency services available to them.<\/p>\n

\u201cI want to assure our retired employees that the JHMB (Joint Health Management Board), in coordination with the district\u2019s benefits team and external consultants, have been and are actively evaluating all options, reviewing data requested from Aetna, and assessing potential paths forward,\u201d said Superintendent Misty Her in a statement on Monday.<\/p>\n

Previously, district Chief Financial Officer Patrick Jensen told the board that the district\u2019s contract with Aetna could be cancelled if Aetna isn\u2019t able to maintain coverage with a major local hospital.<\/p>\n

Originally, the board had approved the contract with Aetna to prevent any gaps in coverage for the rest of the retirees who would not be impacted by the negotiations.<\/p>\n

While cancelling the contract with Aetna could allow the district to switch all retirees to a different provider, Jensen warned that such a process could take six months to complete.<\/p>\n

According to an update posted on their website on Dec. 30, the JHMB<\/a> noted that enrolled retirees may continue to receive care from out-of-network providers, but only if:<\/p>\n

Services provided are covered by Medicaid<\/p>\n

The provider is willing to bill Aetna as out-of-network<\/p>\n

The provider is willing to provide care<\/p>\n

Aldo De La Torre, division president of Community\u2019s insurance services & managed care, also shared with Fresnoland that those who were receiving care at Community may be able to request for a continued care provision.<\/p>\n

\u201cIf a patient in this group is in active treatment with a Community Health Partners physician, they can request authorization from Aetna for a \u2018continuity of care\u2019 provision,\u201d De La Torre said in an email to Fresnoland.<\/p>\n

\u201cThis would allow Community providers to continue to provide services for up to one year upon Aetna\u2019s approval to allow ample time for the patient to transition to another provider while still receiving the care they require.\u201d<\/p>\n

It wasn\u2019t immediately clear when the Fresno Unified school board planned to revisit the issue.<\/p>\n

\n\tRelated<\/p>\n","protected":false},"excerpt":{"rendered":"What’s at stake? Fresno Unified could drop the lapsed insurance contract, but officials say the process would take…\n","protected":false},"author":2,"featured_media":122341,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[112,114,113],"class_list":{"0":"post-122340","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-fresno","8":"tag-fresno","9":"tag-fresno-headlines","10":"tag-fresno-news"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/122340","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=122340"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/122340\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/122341"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=122340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=122340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=122340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}