Your Premera Plan

Contract negotiations with Samaritan Healthcare

Aug 11, 2023 | 5 minutes read

Updated 11/20/2023

Samaritan Healthcare and Premera have come to an agreement on a 1-year contract, providing no disruption to Premera patients receiving care at Samaritan Hospital or clinics. This 1-year contract is effective through December 31, 2024.

The new contract allows members across all Premera lines of business (commercial and individual) to retain in-network access to healthcare services in 2024. Discussions on a long-term contract continue.

Premera and Samaritan entered negotiations with the goal of continuing to provide access to local high-quality care for those ensured by Premera, as well as fair reimbursement for services provided. The new contract represents collaboration between two organizations that aims to provide stability and access to care for patients throughout Central Washington.

We appreciate the patience and understanding of our community members as we’ve worked through this. Premera remains committed to reaching a multi-year agreement that ensures there is no disruption for Samaritan patients and our members.

 


Original Post

As part of its negotiation process, Samaritan Healthcare issued a termination notice to Premera Blue Cross, effective December 31, 2023. Premera is working with Samaritan Healthcare to renegotiate our contracts, which impact all commercial plans, along with Premera Blue Cross individual plans and LifeWise Health Plan of Washington members. These negotiations do not impact Premera members with Medicare Advantage plans or Medicare Supplement coverage.  

The contracts currently under negotiation include Samaritan Healthcare and clinics, which are the facilities, and Association of Samaritan Physicians, which includes all Samaritan-employed providers. 

Our intent with these negotiations is to ensure our members continue to have access to affordable, quality healthcare. As we’ve always said, these negotiations are not about Premera; they are about our customers. We serve as their advocate during these discussions.   

Since March 2022, Premera Blue Cross has been working in good faith with Samaritan Healthcare to renegotiate contracts. We’re grateful for the patience of our customers as we work hard with our partners at Samaritan Healthcare to finalize our contracts.

UPDATE: To learn more about how Premera is working to keep healthcare affordable in Grant County, read our op-ed setting the record straight on our negotiations with Samaritan Healthcare.

Will I be charged for getting emergency care at Samaritan Healthcare if they leave the Premera network?   

If we do not reach an agreement by December 31, 2023, you will still be able to get emergency care at Samaritan Healthcare facilities. Emergency care is always covered at the in-network cost under the No Surprises Act. Wherever you receive emergency care, you are protected from surprise (or balance) billing by state or federal law. This means the most the provider or facility may bill is the plan’s in-network cost-sharing amount (such as copays and coinsurance) and you cannot be billed for any costs above the in-network rate.   

What do I do if I have a long-term treatment plan, am scheduled to deliver a baby, or have a chronic medical condition treated at Samaritan Healthcare?   

If you are receiving treatment for a covered serious, complex, or chronic medical condition at any Samaritan Healthcare facility, you may qualify for continuity of care benefits. This includes pregnancy, long-term or chronic illness, or a scheduled nonelective surgery. If approved, you can continue your care at Samaritan Healthcare at the current in-network benefit level for up to 90 days. Contact our customer service team for more information about this process.   

What happens next?  

Through December 31, 2023, regardless of the ongoing negotiations, you may still receive care from Samaritan Healthcare providers and associated facilities on an in-network basis. Beginning January 1, 2024, if a new agreement is not reached, non-emergency care may not be covered or will cost more out of pocket if you receive care from Samaritan Healthcare providers and facilities.    

We will keep you updated as negotiations continue with Samaritan Healthcare. Look for updates right here. If we can’t reach an agreement, or if you want to find another in-network doctor or health care professional, we’ll work with you to safely move your care.    

If you would like more information on doctors in your area, you can use our Find a Doctor tool or call us at the phone number listed on the back on your ID card.      

Click here to learn more about the process behind provider negotiations. 

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