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Oaklawn to terminate contract with Meridian and Molina due to ongoing issues
IMPORTANT UPDATE 12/22/2023:
We are pleased to announce that Oaklawn has come to new agreements with the folks at Meridian and Molina. Oaklawn has rescinded our notices of termination. Meridian and Molina enrollees will be able to be treated by Oaklawn, our employed physicians, and our affiliated entities on an in-network basis through the new and coming years.
Individuals can enroll in coverage through the Health Insurance Marketplace, or directly with an insurance company, during the annual open enrollment period from November 1, 2023 through January 15, 2024. To shop and compare available health plans, consumers can visit HealthCare.gov or call 800-318-2596. For free local help, visit LocalHelp.HealthCare.gov. DIFS also provides a list of authorized health insurance companies and Health Maintenance Organizations (HMOs) at www.michigan.gov/DIFS.
Over the years, Oaklawn has worked very hard to provide high-quality healthcare at a reasonable cost for patients. Through contracts with insurance plans, patients can access care on an “in-network” basis, taking advantage of the discounts Oaklawn has extended to contracted partners.
For quite some time, Oaklawn has been working diligently with Meridian and Molina toward the positive resolution of many issues.
“Our team members have gone to heroic measures and have shown an enormous amount of patience in their efforts to get Meridian to fix these ongoing problems,” says Chief Financial Officer, Andrew Poole.
“Unfortunately, a large number of old issues remain unresolved and new ones are being identified on a daily basis. We no longer have confidence that Meridian and Molina can resolve these existing issues or new issues from forming,” he added.
As a result of Meridian and Molina’s continued refusal or inability to resolve open issues, Oaklawn has no choice but to issue a letter of contract termination to Meridian and Molina. In following the terms of their contract with Meridian and Molina, Oaklawn is providing Meridian and Molina with formal notice of its intent to terminate their contract, effective Dec. 31, 2023.
The termination of this agreement means that, as of Jan. 1, 2024, Oaklawn (and all of its affiliated physicians and health care providers) will no longer be considered “in-network” for Meridian and Molina’s health plans.
We value all of our patients and encourage them to choose from one of our other contracted payors on the included list as their new health plan partner, so that Oaklawn Hospital and Oaklawn providers will continue to be in-network for them.
Patients should contact their insurance carrier, MI Enrolls at 1-800-975-7630, or the Michigan Department of Medicaid at 1-888-367-6557 to learn what their options are and how they might go about choosing another health plan partner. Below is a listing of the plans with whom Oaklawn is “in-network” now and into the coming year. For further questions, patients should contact Oaklawn’s Patient Financial Services office at 269-789-7000 or oaklawnhospital.org/contact.
“Thank you for your understanding and patience while we go through this transition period,” Poole added. “It is my sincere hope that you continue to choose Oaklawn (and our affiliated physicians and providers) as your health care partner going forward.”
A breakdown of plans that Oaklawn continues to participate with are shown below.
Alternate Plans to Meridian Health Plan Medicaid
- McLaren Medicaid
- Priority Health Medicaid
- UnitedHealthcare Community Plan
- Aetna Better Health
- Blue Cross Complete
Alternate Plans to Meridian Health Plan MI Health Link (dual eligible)
- UnitedHealthcare Dual Complete
- Aetna Better Health Premier MI Health Link
Alternate Plans to Meridian Health Plan Wellcare Advantage
- Aetna Medicare
- Medicare Plus Blue
- Blue Care Network (BCN) Advantage
- Physicians Health Plan (PHP) Medicare
- Priority Health Medicare
- UnitedHealthcare Medicare
Alternate Plans to Ambetter Meridian Health Exchange
- Priority Health Exchange
