Notice to Those with Aetna

From the Department of Central Management Services: The Illinois Department of Central Management Services (CMS) has been advised that Aetna and Memorial Health Systems in Central Illinois are currently in ongoing negotiations for the provider contract that is set to expire on 4/1/2023.  This negotiation impacts both Memorial affiliate hospitals and their physician groups.  The Aetna HMO, OAP, QHCP, the Consumer Driven Health Plan (high deductible) and MAPD are impacted.

Discussions are ongoing between the parties. Notice providing the steps that must be taken to select a new physician or address any transition of care needs were mailed to Aetna HMO, OAP, QCHP and CDHP members utilizing one of the hospitals or physicians impacted on 2/1/2023.  If Aetna and Memorial have not reached an agreement by 3/1/2023 the same notice will be sent to TRAIL MAPD members in accordance with Federal Medicare requirements.

CMS is hopeful that Aetna and Memorial Health Systems will come to an agreement to continue to provide health care to our MAPD and active employee population.  CMS is not a party to the provider contract issues/negotiations.

CMS Benefits has been informed by Aetna that even if the worst should happen and the contract is not renewed, the provider network is still adequate with the hospitals which remain in the network such as HSHS/St. John’s Hospital in Springfield.  This does not impact the SIU School of Medicine Clinic/Doctors that are associated with Memorial Hospital in Springfield which also have a relationship with HSHS/St. John’s Hospital.