Thursday, April 19, 2018
News Roundup

AARP Medicare plans end relationship with Moffitt Cancer Center

PALM HARBOR — Ed Kraycik has been in an AARP HMO since he went on Medicare eight years ago. That streak is about to end.

In 2014, AARP's MedicareComplete HMO will cease covering treatment at Tampa's H. Lee Moffitt Cancer Center. That's a priority for Kraycik because a friend of his died at another hospital after a botched cancer surgery.

"I don't have cancer, but if I ever do, there's only one place I want to have surgery, and that's Moffitt,'' Kraycik said. "It's one of the premier cancer centers in the country, so this is serious.''

Medicare's open enrollment period, when people pick their coverage for next year, is Oct. 15 to Dec. 7. Health and drug plans bearing the AARP name and administered by United HealthCare, are among the most popular products on the market.

Last year, AARP plans lost hundreds of Tampa Bay members while United HealthCare and BayCare Health System haggled over payment rates. The dispute affected about 400,000 people of all ages in a variety of insurance plans. The Moffitt change is limited to AARP's MedicareComplete plans: one HMO and two PPOs.

More than 51,000 people in Hillsborough, Pinellas and Pasco counties are enrolled in those MedicareComplete plans, a United spokeswoman said.

For several years, the MedicareComplete plans treated Moffitt and doctors in its medical group as if they were network providers, even though they were not. Plan members made small, pre-established copayments and the plans paid the balance.

But as of Jan. 1, MedicareComplete's HMO members will have no coverage at Moffitt. PPO members will have to pay, out-of-pocket, the out-of-network rate, which was $375 a day in 2013.

AARP/United HealthCare Medicare drug and supplement plans are not affected. Nor are other United HealthCare plans.

The MedicareComplete arrangement with Moffitt "was intended to be short-term,'' United HealthCare spokeswoman Sarah Bearce said in an email. "Over the years, many of the hospitals in the Tampa area have improved their cancer treatment/specialty care capabilities. Our members in need of cancer treatment can receive appropriate care at the hospitals that participate in our network.''

Moffitt is "very disappointed,'' said chief financial officer Janene Culumber. Roughly 2,500 AARP members received some kind of screening or treatment at Moffitt in 2012 — about 5 percent of the cancer center's caseload.

United "did not ask us for a rate decrease or anything,'' Culumber said. Moffitt takes Medicare rates for these patients so she was unsure how the insurer's decision would save money. "They just decided they would make these patients out of network,'' she said.

Russell Silverman, executive director of the Florida Breast Cancer Foundation, called United's move "a bad decision."

"Moffitt is a well-respected cancer institution. Any insurer ought to have a relationship with an institution of that quality," he said.

United is shedding little light on reasons behind the action. Silverman suspects it believes it might save money if its enrollees get cancer care at a general, rather than speciality, hospital.

Four companies that do include Moffitt in their networks will offer Medicare plans in the bay area in 2014: Aetna, Blue Cross, Blue Shield, Coventry and Humana.

Contact Stephen Nohlgren at [email protected]

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