Military Insurer Cuts Ties with Samaritan Specialists

Military Insurer Cuts Ties with Samaritan Specialists

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Health insurance provider Humana Military has cut ties with a number of specialty practices linked to Samaritan Medical Center after reimbursement rate negotiations fell through.

Humana Military is one insurer providing coverage, via TRICARE, to Fort Drum soldiers, retirees, and their families. In a statement Wednesday, Fort Drum Medical Command (MEDDAC) announced Humana will no longer refer its patients to some specialists working through Samaritan Medical Practice. Those specialists provide a variety of services, including radiation oncology, vascular surgery, OB/GYN, and orthopedic surgery.

"They're still going to get referrals to off-post providers," MEDDAC spokesman Warren Wright said. "It just won't be under the Samaritan Medical Practice... So, Humana Military is developing relationships with more of our local and surrounding area providers in an effort to help bridge that gap."

The move appears to hinge on stalled negotiations over the amount of money Humana Military pays Samaritan Medical Practice for providing care. In a statement, Samaritan spokesperson Krista Kittle wrote Humana Military “was demanding a discount off the rate established by Congress.”

Kittle says Samaritan Medical Practice operates at a loss and can't absorb any further rate reductions.

"It's a concern and we were hoping we could solve it at the table during negotiations, but it didn't work," Kittle said. "Think about the inconveniences now, that soldiers and their families and the retirees are going to have to face if they have to get these services elsewhere outside of the area, out-of-pocket costs."

Samaritan officials say they're committed to serving the military community and hope Humana reconsiders its decision. Kittle  says the decision affects 10 of Samaritan Medical Practice's 45 specialty providers.

It's important to note, this affects specialist care, not services provided by Samaritan Medical Center itself. Humana Military patients can still use Samaritan's emergency room and urgent care facilities.

The change applies to new or changed referrals. Any Humana Military patient currently using a Samaritan specialist for treatment will continue to do so until that treatment is completed.

7News reached out to Humana Military for comment and we're waiting to hear back.

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