CHARLESTON, W.Va. -- Humana, a Lexington, Ky.-based company that provides Medicare supplement plans, will no longer pay for medical visits and care at Thomas Memorial Hospital in South Charleston and Saint Francis Hospital in Charleston after Feb. 1.
Stephen P. Dexter, CEO of the Thomas Health System, found out about Humana's decision on Dec. 6, when he received a letter, dated Nov. 30, from Beverly Steen, Humana's director of contracting.
Steen's letter provided no detailed explanation about why Humana was withdrawing from its contracts with the Thomas Health System.
"The dynamics in the Charleston area have changed and the ChoiceCare network is reconfiguring its network," Steen wrote. "Your ChoiceCare Network agreement is terminated without cause effective 2/1/2012 for all lines of business."
In her letter, Steen said the "agreement [between Humana and Thomas] shall automatically renew for subsequent one-year terms unless either party provides written notice of non-renewal to the other party at least 90 days prior to the end of the initial term or any subsequent renewal terms."
During an interview last week, Dexter said, as of now, "We are still in the network. We want to stay in the network. Our doctors want to stay in the network."
Paige Johnson, director of marketing and public relations for the Thomas Health System, said, "There has been nothing wrong done by either hospital in the services we provide.
"This was a complete blindside," she said. "We will do everything we can to contest this issue."
Dexter believes "Medicare patients ought to be able to choose their hospitals and doctors. Denying them that choice is not part of the Medicare program.
"We think this is totally inappropriate. We want our patients to contact our elected officials," he said.
Sen. Jay Rockefeller, D-W.Va., who follows health issues closely, said on Saturday, "I'm currently looking into this situation. Seniors absolutely must be able to get access to quality, affordable health care."
Joe Kuchler, a press officer for CMS, based in Washington, D.C., said on Friday that his agency will look at Humana's relationship with the Thomas Health System early next week and answer questions.
(CMS stands for the Centers for Medicare & Medicaid Services -- the federal agency that administers Medicare, Medicaid and the Children's Health Insurance Program.)
Steen's letter to Dexter gave the Thomas Health System a 56-day notice, with no specific explanation about reasons for the termination.
In a Dec. 22 letter to Steen, Dexter pointed out that "...as correctly noted in your letter, at least 90 days of written notice of non-renewal to the other party must be given.
"This has not been done. For this reason, the agreements continue in full force and effect." Dexter wrote in his letter.
"All of a sudden, some of our patients were told, 'Your hospital is no longer in the plan.' Some people have been our patients for 30, 40 or 50 years," Dexter said.
"When patients come into the ER [emergency room], the nurses know their names. Patients know their doctors. At a new hospital, patients won't know anyone. They will be taken out of their element of comfort."