Humana agreement finally reached

The Clark Fork Valley Hospital is excited for local residents with the agreement of Humana’s participation in their Medicare Advantage Program now in place.

There status as a participating healthcare facility, along with each of their Family Medicine Network office and providers, which will be effective retroactively to Jan. 1, 2018.

The local hospital was informed back in October of 2017, just prior to the beginning of open season for Medicare enrollments that Blue Cross Blue Shield of Montana would be axing their Medicare Advantage coverage for Sanders County residents.

That decision left many members under the Blue Cross Blue Shield Medicare Advantage scheme with limited options for a financially sustainable Medicare option plan for 2018.

“We then learned that Humana Medicare was being marketed to Sanders County residents, despite the fact that Clark Fork Valley Hospital was not a participating provider with them,” said hospital representative Tonya Revier.

“We have been working through Monida Healthcare Network, our contracting representative, to negotiate a contract since that time,” she added.

“We regret the ongoing frustration this situation has caused among our local Medicare beneficiaries who enrolled in Humana Medicare for 2018 prior to our having a provider contract in place,” said Carla Neiman, CFO at Clark Fork Valley Hospital.

“This situation posed a potentially catastrophic impact on access to care for some of our most vulnerable residents and we feel very fortunate that we were able to finally address it with a Humana agreement,” she continued to say.

“If you are a Humana Medicare enrollee who was assigned a Primary Care provider outside Sanders County, you will now be able to choose a Clark Fork Valley Hospital provider to manage your care. We are in the process of inquiring about the procedure to make that change,” said Revier.