Neishloss& Fleming Inc.

The current agreement between HealthAmerica and Conemaugh Health System will expire November 6, 2011.  HealthAmerica has been unable to reach a mutual agreement on the terms of a contract with Conemaugh Health System.  As a result, Conemaugh Health System’s facilities and affiliated providers will be out-of-network providers for HealthAmerica’s commercial group, individual and Medicare Advantage members, effective November 7, 2011.  This assumes there is not an agreement that is worked out in the next few weeks.

HealthAmerica hopes to continue negotiations to reach an agreement.   The Commonwealth of Pennsylvania requires insurance carriers to give members a 30-day notice in the event of a contract termination. If an agreement is not reached, the contract with Conemaugh Health System expires on November 6, 2011. As of November 7, 2011, the following hospitals and owned physician groups will no longer be part of the network:

• Meyersdale Medical Center
• Memorial Medical Center
• Miners Medical Center
• Conemaugh Health Initiatives

This termination will also include network providers who have admitting privileges exclusively at Conemaugh Health System facilities.

Effective November 7, 2011, any non-emergent care that members receive from Conemaugh Health System facilities or providers, other than transitional care, may be covered as out-of-network or denied (if the member does not have out-of-network coverage). If the group has a plan with out-of-network benefits, higher deductibles and coinsurance may apply. To ensure their members have as little disruption as possible,  HeathAmerica encourages members to use area hospitals in the HealthAmerica network to maximize their benefits and avoid potential costs from using a nonparticipating provider. The nearest alternative participating facilities are Windber Medical Center, Altoona Regional Health System, Somerset Hospital, and Latrobe Area Hospital.

For more details and to read further on transitional care, please read the document below:

We have just received news that HealthAmerica has signed a new contract with Armstrong County Memorial Hospital.  This contract applies to all of HealthAmerica’s products, which include Medicare Advantage, Group Medical, and Individual Medical.  Here are the direct quotes from the news release:

Armstrong County Memorial Hospital and HealthAmerica have reached an agreement that ensures HealthAmerica members can continue receiving health care services from the hospital.    Under the new, multi-year agreement, HealthAmerica members will con­tinue to have access to the hospital as well as any health system-affiliated companies.

The new agreement avoids a potentially disruptive contract termination and means our members in Armstrong and surrounding counties can continue to receive services close to home.    The contract applies to all of HealthAmerica’s product lines.     Members and providers previously notified of the termination will be notified in writing that an agree­ment was reached.

HealthAmerica has a responsibility to keep costs affordable for our customers.   We strive to balance equitable reimbursements to hospitals while fulfilling our obligation to customers to contain health care costs.

We realize our members value the services offered by the Armstrong County Memorial Hospital and regret the inconvenience a contract termination would have caused.