Genesis HealthCare System in Zanesville has reached new agreements with CareSource and Aetna that will keep many Muskingum County patients in network through 2027, according to a release from Genesis reported by the Zanesville Times Recorder.
CareSource Medicaid, the Next Generation MyCare Ohio Plan and Aetna Medicare Advantage members will maintain in-network access to Genesis through 2027 under the new deals, the Times Recorder reported.
The agreements come nearly two months after Genesis announced that 9,000 denied and disputed claims from four providers, and millions of dollars in losses, had weighed on its future contracts, according to the Zanesville Times Recorder.
Genesis had previously said it would end contracts on Jan. 1 for Medicare Advantage plans under Aetna, UnitedHealthcare and Medical Mutual of Ohio, and for Medicare Advantage and Medicaid plans under CareSource, unless new agreements were reached, the Times Recorder reported.
Genesis said it anticipates releasing another announcement on the other insurance plans in the near future, according to the Zanesville Times Recorder. Existing coverage for the remaining plans stays unaffected through Dec. 31; without agreements, those plans would become out of network for nonemergency care at Genesis on Jan. 1.
Genesis has said it does not send surprise bills to patients that it believes should be covered by insurers, the Times Recorder reported. Commercial employer-sponsored plans and traditional Medicare supplement, or Medigap, plans are not affected.
Patients with questions can check the Genesis website or call the Patient Financial Advocate Hotline at 740-454-4335, according to the Zanesville Times Recorder.
The dispute behind the talks was about payment, not care. Genesis announced last month that rising coverage denials and payment disputes with insurers had forced it to reconsider which plans it could accept, according to the Zanesville Times Recorder — a position hospital systems across Ohio have increasingly taken as denial rates climb.
For patients, the practical question is whether their doctor and hospital stay in network on Jan. 1. With the CareSource and Aetna deals signed, the remaining uncertainty centers on the UnitedHealthcare and Medical Mutual of Ohio Medicare Advantage plans, which Genesis has said will go out of network for nonemergency care on Jan. 1 if no agreement is reached, according to the Times Recorder.
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