State employees, including teachers, have lost full access to one of the state’s only level one trauma centers.
The Medical Center of Central Georgia in Macon has stopped providing “in-network” coverage to state employees using United Health Care's PPO. If patients are admitted to the hospital they will be responsible for their bills. Those with United Health care's HMO are not covered at all except in the emergency room.
Medical Center CEO Don Faulk says UHC failed to honor its contract with the hospital when the company suddenly began reimbursing the hospital at the same rate whether patients had an HMO or PPO.
“To have a contract that had two rates firmly established and for them to move whatever that block of business in the PPO just over to the HMO rate was just not, that wasn’t part of the deal.”
Faulk says the change cost the hospital a half-million dollars a month. Six percent of the Medical Center’s patients use state UHC plans.