CIGNA and UNC Health in showdown


Click here to read the letter (.pdf)

If the contract expires, UNC healthcare - including UNC Hospitals, UNC Physicians and Associates, Rex Healthcare, and Rex Physicians - would be considered "out of network," and patients would have to go elsewhere or pay considerably more to use UNC services.

The two companies are arguing over the rates used to reimburse hospitals for services. UNC's letter says it is trying to negotiate a "fair and equitable" contract and urges patients to contact CIGNA.

"There is no reason for CIGNA to reject a fair contract," reads the letter in part. "And there is no reason people should have to pay more to go to the doctor or hospital of their choice."

But when ABC11 contacted CIGNA for a comment Tuesday, it said UNC is requesting rates that are nearly twice what Medicare has established as fair reimbursement in North Carolina.

"This is difficult to imagine in a state with one of the highest levels of unemployment," said CIGNA's statement. "The fair rates offered by CIGNA would provide market competitive reimbursement for hospital and physician services."

Click here to read the statement (.pdf)

CIGNA also said most of its North Carolina clients are self-funded. Meaning they pay medical costs for employees directly and CIGNA just manages the insurance claims. It says the higher rates UNC wants go directly to the bottom line of companies hit hard by the recession.

"As a result of this demand, UNC/REX hospitals and affiliated physicians will no longer be considered “in-network” effective January 1, 2010," said the statement.

CIGNA said it will work with patients to help them transition to new doctors.

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