Aetna Network Update: Dignity Health Terminates April 1, 2024

Central Valley/Los Angeles/Northern California Aetna network – Termination with Dignity Health for an April 1, 2024, effective date

The contract with Dignity Health in California is set to expire on 04/01/2024 for all hospitals, surgery centers, clinics, fee for service physicians, and ancillary providers. The HMO capitated medical groups have a separate termination date of 07/01/2024.

Negotiations are ongoing and both parties are continuing further discussions in hopes to reach an acceptable agreement.

While Aetna wants Dignity Health to remain in network, they have a network of health care providers that can meet member’s health care needs in most of the communities where Dignity Health operates. But there may be some coverage gaps for certain lines of business in some markets. In areas where there are gaps, Aetna will assist members to obtain the care that they need.

Alternate Hospitals

You can find network hospitals and physicians by using Aetna's online provider search tool “Find a Doctor”.

Impacted Networks

The following products are part of the negotiation with Dignity Health CA:

Member Letters

• Letters to Commercial HMO and PPO members as a result of hospital/physician group terminations will be mailed on/around 04/05/24.
• Letters to Commercial HMO members assigned to Dignity capitated groups (termination effective date of 07/01/2024) will be mailed on/around 05/01/2024.

Transition of Care

Aetna wants to help maintain continuity of care coverage if any employee is currently undergoing treatment for serious illness, pregnancy or injury with a specialist affiliated with the affected facility. In such an instance, Aetna's National Precertification clinical staff will review these cases and, when necessary, offer assistance to members who may require transition of care coverage by directing the member to Aetna Member Services or the online provider search tool at aetna.com.

For a limited time and when appropriate, Aetna will cover certain ongoing medical care for a serious illness for a specified period at the preferred level of benefits, rendered by a specialist who no longer participates in the network.

For self-insured plans
Aetna’s standard Transition of Care Coverage Policy will apply to members actively in a course of treatment.

For fully insured plans
As required by law, Aetna’s California addendum to its standard Transition of Care Coverage policy provides for completion of covered services for:

• Acute conditions
• Severe Chronic conditions
• Pregnancy
• Terminal Illness
• The care of a child ages 0-36 months
• Previously scheduled surgery or other procedures

Please reach out to your Amwins Connect Sales Representative with questions.