On Jan. 1, Aetna\u2019s Medicare Advantage Plan removed Community from their network of care after the two failed to reach a contract agreement. The two organizations are continuing negotiations.<\/p>\n
![\"\"](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/01\/Manuel-Bonilla-Portrait.jpg\")
<\/p>\n
\u201cOur message to Community is clear. Restore retiree health care access now\u201d<\/p>\n
\u2014 Fresno Teachers Association President Manuel Bonilla<\/p>\n
\u201cOur message to Community is clear. Restore retiree health care access now,\u201d Fresno Teacher Association President Manuel Bonilla said at the conference. \u201cIf you refuse, you will only further expose that our retirees are being used as bargaining chips in a contract dispute.\u201d<\/p>\n
In the meantime, Fresno Unified and union leaders said Community needs to take action to support retirees. Her said Community could give an extension of care during the negotiation period or accept Medicare reimbursement rates.<\/p>\n
Community\u2019s division president of insurance services and managed care, Aldo De La Torre, said the hospital needs a contract that adequately reimburses hospitals for their care. De La Torre said they \u201cshare the concerns and frustrations with Fresno Unified retirees.\u201d<\/p>\n
\u201c(We) are committed to reaching an agreement that allows us to continue providing high-quality care at a fair rate,\u201d De La Torre said in a statement to GV Wire. \u201cOur ability to provide high-quality, accessible care to the entire community depends on contracts that fairly reimburse physicians, nurses, and care teams for the services they deliver. To date, Aetna has not offered terms that meet that standard.\u201d<\/p>\n
Community recently contacted the district to set up a meeting, according to Fresno Unified Trustee Susan Wittrup.<\/p>\n
Retirees Lose Community as In-Network Provider<\/p>\n
The dispute caused hundreds of Fresno Unified retirees to lose easy access to the region\u2019s largest healthcare provider.<\/p>\n
About 6,500 retirees and dependents are enrolled in the program, and 1,500 received primary care services at Community, according to the district.<\/p>\n
Community has prompted retirees to request authorization from Aetna through a \u201ccontinuity of care.\u201d<\/p>\n
\u201cThis would allow Community providers to continue to provide services for up to one year upon Aetna\u2019s approval,\u201d De La Torre said. In the meantime, the health system will continue to provide emergency care to everyone affected.<\/p>\n
\u201cOur ability to provide high-quality, accessible care to the entire community depends on contracts that fairly reimburse physicians, nurses, and care teams for the services they deliver. To date, Aetna has not offered terms that meet that standard.\u201d<\/p>\n
\u2014 Community Medical Centers Division President Aldo De La Torre<\/p>\n
But \u201ccontinuation of care\u201d only covers a narrow scope of healthcare and patients, according to Fresno Unified CFO Patrick Jensen.<\/p>\n
\u201cThat term does a lot of heavy lifting, when in reality, the legal requirements for that is it only covers a very small segment of the population,\u201d he said. \u201cSo I just want to be very clear to say that the continuation of the care provision is not a solution for the vast majority of our members.\u201d<\/p>\n
The district is willing to escalate the issue if Community does not act.<\/p>\n
\u201cI think if this isn\u2019t resolved, those reports and those formal grievances are going to be looked at, if this needs to escalate into some call to the attorney general or some lawsuit or demand that comes next, I don\u2019t know. I\u2019m hoping we don\u2019t go there,\u201d School Board President Veva Islas said. \u201cI\u2019m hoping that our call to action is respected and that in short order things do change.\u201d<\/p>\n
Some Retirees Seek Traditional Medicare<\/p>\n
A group of retirees are advocating for a return to traditional Medicare, saying Aetna\u2019s Medicare Advantage Plan has failed them.<\/p>\n
About 15 retirees attended the press conference, with one demanding answers during a tense moment with Bonilla.<\/p>\n
\u201cSome of our folks don\u2019t like Medicare Advantage, and we\u2019re hearing that,\u201d said Jon Bath, a member of the Joint Health Management Board. \u201cSo (JHMB is) going to move on that. We\u2019re going to be decisive. We\u2019re going to do it Thursday and we\u2019ll move fast as we can through the regulatory procedures.\u201d<\/p>\n
JHMB \u2014 comprised of union representatives and district staff \u2014 is responsible for negotiating district staff and retiree healthcare plans.<\/p>\n
However, a similar situation to what is occurring now could affect those on traditional Medicare, Jon Bath.<\/p>\n
But the complaints of people demanding traditional Medicare don\u2019t stem from the current issue.<\/p>\n
\u201cI\u2019ve heard from people that have been on the Medicare Advantage plan when negotiations were not happening, when everything was supposed to be normal. They\u2019re getting denied right and left on medicine and procedures,\u201d Wittrup said. \u201cAnd they\u2019re just really giving them the runaround.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Fresno Unified and the Fresno Teachers Association joined forces Monday to demand Community Medical Centers provide health care…\n","protected":false},"author":2,"featured_media":131032,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[112,114,113],"class_list":{"0":"post-131048","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\/131048","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=131048"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/131048\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/131032"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=131048"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=131048"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=131048"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}