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Jul 14, 2011 3:19 PMPublication: The Southampton Press

Deadline Looms For Oxford And East End Health Care Alliance

Jul 14, 2011 5:12 PM

At midnight on Friday, a contract between the East End Health Care Alliance and United Healthcare/Oxford expires, meaning that some 3,000 East End residents who use Oxford’s self-insured plans could have to pay costlier, out-of-network rates at local hospitals.

And those familiar with the negotiations say that a new deal is not close to being reached.

“At this point, I really don’t have good news,” Paul J. Connor, a spokesman for the alliance, said on Thursday afternoon, adding that he expects discussions between the two sides to resume.

He added that the alliance, which comprises Southampton Hospital, Peconic Bay Medical Center in Riverhead and Eastern Long Island Hospital in Greenport, is seeking market-rate reimbursement rates from the carrier.

“The current level of reimbursement from United Healthcare/Oxford and the proposed increases are inadequate to sustain our quality goals,” reads an alliance statement.

Maria Gordon-Shydlo, a spokeswoman for United Healthcare/Oxford, said on Thursday that a statement she emailed last month still applied: “East End Health Alliance has requested a significant percent rate increase for the remainder of this year followed by another significant increase for 2012 that would adversely affect thousands of United Healthcare and Oxford members and clients.”

If the two sides fail to reach an agreement, certain care, such as emergency room treatment, will still be covered.

An additional 12,000 enrollees—those who are enrolled in fully insured plans with Oxford, such as Oxford Liberty and the Oxford Freedom Plan—have until September 15 before going out of network due to a 60-day “cooling-off” period, both sides said.

United Healthcare/Oxford is the second-largest health care insurer in the region, behind Empire BlueCross BlueShield.

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This is inaccurate information - only self-funded plans with Oxford/United will be affected tomorrow after midnight. Anyone with Oxford Freedom or Oxford Liberty plan will still be able to use the hospital until Sept 15th, which if at that point no contract is created will most East End residents be affected. http://www.southamptonhospital.org/News/NewsDetail.aspx?a=4330
By aschor06 (9), Sag Harbor on Jul 14, 11 3:52 PM
That is correct, the article has been corrected to reflect the more accurate information.
By Bill Sutton, Managing Editor (117), Westhampton Beach on Jul 14, 11 4:58 PM