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Aetna and Community Medical Centers and Community Health Partners have failed to reach a resolution on a contract extension, leaving some Fresno teacher retirees without coverage. Photo illustration by Cecilia Lopez\n<\/p>\n
This story was originally published by Fresnoland<\/a>, a nonprofit news organization.<\/p>\n Fresno Unified School District leaders on Monday called on Community Health System to allow retired district employees access to its services, saying that Community has refused care to retirees amid unresolved negotiations.<\/p>\n Specifically, one of the district\u2019s insurance providers, Aetna, was not able to resolve negotiations with Community on their own by a Dec. 31 deadline. That day, Community\u2019s facilities were rendered out-of-network for about\u00a01,500 FUSD retirees<\/a>\u00a0on Medicare who received care primarily at Community.<\/p>\n Superintendent Misty Her was joined by\u00a0Fresno Teachers Association<\/a>\u00a0President Manuel Bonilla, the FUSD Board of Education and the\u00a0Joint Health Management Board<\/a>\u00a0(JHMB) during Monday\u2019s news conference.<\/p>\n \u201cOver the past two weeks, my office, our district team and our trustees, have been inundated with messages from retirees,\u201d Her said. \u201cThey have shared countless alarming accounts of doctors abruptly discontinuing their care, delays or denials in accessing medications and being turned away from essential services.\u201d<\/p>\n Her said that the JHMB executive committee has been communicating almost daily about this matter since Jan. 1.<\/p>\n \u201cLast Friday, Fresno Teachers Association and the Joint Health Management Board met with us in identifying a solution in light of Community Medical Center\u2019s failure to do so, and I am grateful for their willingness to collaborate,\u201d Her said.<\/p>\n According to Her, the JHMB will meet on Thursday to vote on alternative options to provide care to retirees. District leaders did not share any details about what alternatives are under consideration.<\/p>\n Bonilla, the teachers union president, said that the contract dispute has been transformed into a healthcare crisis by Community, saying refusal to return healthcare access to retirees would \u201conly further expose that our retirees are being used as bargaining chips in a contract dispute.\u201d\u2028\u2028<\/p>\n Additionally, Bonilla noted that despite the unresolved negotiations, Community can still provide care to the retirees and receive reimbursement for doing so, but has chosen to do otherwise.<\/p>\n \u201cAgain, to be absolutely clear, Community Regional Medical has an option, and always has had an option, to continue to provide services to our retirees during this negotiation process and simply bill the insurer carrier for reimbursement,\u201d Bonilla said. \u201cThat is a typical practice in situations like this across the country, and they chose not to do that.\u201d<\/p>\n In a statement to Fresnoland, Aldo De La Torre, president of Community\u2019s Insurance Services and Managed Care division, reiterated that retirees may request a \u201ccontinuity of care\u201d provision for Aetna to receive services.<\/p>\n \u201cWe are actively negotiating with Aetna and 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 the statement. \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.\u201d<\/p>\n That standard, De La Torre said in the statement, hasn\u2019t been met by the terms that Aetna has brought to the bargaining table so far.<\/p>\n \u201cIf patients are 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 the statement. \u201cUpon Aetna\u2019s approval, this would allow Community providers to continue services for up to a year for that patient.\u201d<\/p>\n \t\t\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Aetna and Community Medical Centers and Community Health Partners have failed to reach a resolution on a contract…\n","protected":false},"author":2,"featured_media":132412,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[112,114,113],"class_list":{"0":"post-132411","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\/132411","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=132411"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/132411\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/132412"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=132411"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=132411"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=132411"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}