WATERTOWN, NY — Samaritan Medical Center has issued the following statement regarding the changes announced by Fort Drum related to its TRICARE health insurance beneficiaries:
Prior to January 1, the soldiers, family members, civilian employees and retirees at Fort Drum were insured through either TRICARE or Martin’s Point. It was announced earlier this year TRICARE’s contracted health insurance provider would be changing from HealthNet to Humana Military (Martin’s Point remains unaffected).
Initially, Humana Military continued to pay Samaritan Medical Practice (SMP) providers at the reimbursement rates established by the Congress and previously paid by HealthNet for the past ten years. Approximately six weeks ago, we received notice that Humana Military was demanding a “discount” off the rate established by Congress. TRICARE reimbursement rates are similar to Medicare reimbursement rates and are set by Congress to reimburse providers at cost. Despite several attempts by SMP to maintain the federally established rates Humana demanded those rates be further discounted if Samaritan Medical Practice was to remain a participating provider.
The Samaritan Medical Practice currently operates at a significant loss from operations, and any reduction from current reimbursement rates was impossible for the practice to absorb. As such, the Samaritan Medical Practice will no longer be considered a participating provider with Humana Military effective January 1, 2019.
Our commitment to serving our military community is core to our mission and continues to be. However, as an organization, we also must ensure the financial stability of the organization long-term. Though regrettable and disappointing, a decision to accept Humana’s demands would not have been fiscally prudent.
We certainly hope that Humana reconsiders this decision to enable Samaritan Medical Practice to continue to meet specialty care locally for our Fort Drum population.
The list of SMP providers referenced in Fort Drum’s release is incorrect.
The following is a corrected list:
GI
ENT
GENERAL SURGERY
PULMONARY (Drs. Sears, Youngblood, Kramer, Keenan ONLY)
OB/GYN
PLASTIC SURGERY
RADIATION ONCOLOGY
ORTHOPAEDICS (Dr. Scott Mollison Only)
THORACIC SURGERY
INTERVENTIONAL RADIOLOGY
