What's at stake?
Community Medical Centers temporarily restores access for retirees' physician visits and prescription refills through Feb. 20.
Fresno Unified Superintendent Misty Her says Community Health System agreed to temporarily restore office visits and prescription refill services to about 1,500 FUSD retirees on Medicare— who abruptly lost health care access on New Year’s Day amid stalled contract talks between the hospital system and an insurance company.
Her gave the news to the FUSD school board during Wednesday night’s regular meeting.
“This morning, our district team and FTA president Manuel Bonilla met with Community leadership, Her said. “As a result, Community Medical Centers has agreed to an extension of access for retirees, covering physician visits and prescription refills through February 20.”
The deal comes a day ahead of a meeting of the district’s Joint Health Management Board, where a potential vote remains on the table to expand access to alternative options for the district retirees.
In a statement to Fresnoland on Wednesday night, Craig Wagoner, president and CEO of Community Health System, said that Community is working with FUSD to provide access to services as they work to reach an agreement with Aetna.
Wagner said Community providers will accept FUSD retirees who are covered by Aetna and allow them access to clinic visits, prescription refills, and the following:
- “Community will certainly provide all emergency services regardless of insurance status.
- We will honor continuity of care provisions for those in active treatment, such as but not limited to, cancer care.
- For all other services, we will continue to request from Aetna approval to provide in[1]network services to FUSD retirees on a case-by-case basis.”
“We are committed to doing everything we can to resolve the contract negotiation with Aetna in a timely manner that also allows us to continue providing high-quality care at a fair rate,” Wagoner said in an email statement.
“However, Community Health System must demand reimbursement that covers the cost of the care we provide so that our region’s most essential healthcare provider—for more than 125 years—remains financially stable to continue serving the needs of our Valley,” Wagoner added.
Community officials have not yet explained what prevented them from offering services to the 1,500 impacted Medicare-age retirees between Jan. 1 and Jan. 14. When asked, spokespersons have dodged the question and, instead, pointed to an application process for retirees to request service extensions.
Beyond increasing public pressure from Fresno Unified leaders this week, it’s unclear how the situation changed for the hospital between Jan. 1 and Wednesday.
