Insurance Wrangling Threatens Coverage of Many WA Residents
Multi Care is a WA non-profit healthcare company that started in Tacoma in 1882. Over the years, it has provided health benefits to dozens of providers across the state. But a contract haggle with Premera could leave many customers without insurance.
Multi Care and Premera trying to re-negotiate new deal
The current contract expires May 31st, and the sticking point is the amount of money Premera provides to Multi for hospital care for those with its plans.
Premera says it has been fair with reimbursements, while Multi says since 2019 Premera's reimbursement rates have been below the rate of inflation. Premera says they are disappointed with the tone of the negotiations from Multi, given their successful working relationship over the years.
If a new contract is not reached by May 31st, thousands of people who have Premera commercial, Individual Exchange and Medicare Advantage health plans will find themselves out of network. If no contract is reached, the following medical facilities will be affected, according to KHQ-TV Spokane:
- Auburn – MultiCare Auburn Medical Center
- Covington – MultiCare Covington Medical Center
- Olympia – MultiCare Capital Medical Center
- Puyallup – MultiCare Good Samaritan Hospital
- Spokane – MultiCare Deaconess Hospital
- Spokane – MultiCare Valley Hospital
- Spokane – Rockwood Clinic
- Tacoma – MultiCare Allenmore Hospital
- Tacoma – MultiCare Mary Bridge Children's Hospital and Health Center
- Tacoma – MultiCare Tacoma General Hospital
- Yakima – MultiCare Yakima Memorial Hospital
- Indigo Urgent Care Clinics
Multi Care was hit with a Federal False Claims Act in January of this year, authorities say it stems from the continued employment of a neurosurgeon who was under investigation between 2019-2021. The surgeon's license was suspended in 2021.
The Federal charges also claim (fiercehealthcare.com)
"The government also alleged that MutliCare’s knowing conduct led to “dozens, if not hundreds,” of materially false and fraudulent claims submissions to Medicare and other federal healthcare programs. Through these, the health system “received millions of dollars in revenue, while unknowing patients were endangered and harmed,” according to the complaint."
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