CareSource: Cleveland Clinic will no longer be a network provider

CareSource said that Cleveland Clinic will no longer serve as a network provider for its Medicaid and MyCare members in Northeast Ohio, the company said late Tuesday.

“In accordance with Ohio state procedures CareSource notified Cleveland Clinic that the relationship would change effective Sept. 1,” Dayton-based CareSource said in a statement. “The provider relationship change comes as Cleveland Clinic has declined to adopt the standard methods of payment established by the Ohio Department of Medicaid.”

“Cleveland Clinic has provided high quality care for our members and we have valued the relationship,” Steve Ringel, CareSource president of the Ohio market, said in the statement. “While we are still hopeful for a resolution, we are required by the Ohio Department of Medicaid to notify our membership 45 days before a potential network relationship change occurs. That notification began this week with a letter informing our members about the change and providing options for alternate high quality health partners.”

CareSource’s announcement came as the Cleveland Clinic said Tuesday that patient coverage talks were continuing.

That contractual relationship expires Sept. 1, a spokeswoman for Cleveland Clinic said Tuesday.

“If the contract ends it would be effective Sept. 1,” Cleveland Clinic spokeswoman Heather Phillips said in an email. “At this point, CareSource members can still come to Cleveland Clinic for their care. We are in the process of sending out information to help our patients as well through this if it does occur.”

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In a statement released later Tuesday, she said: “It’s important to note, Cleveland Clinic is still under contract through Aug. 31, 2017 and in active discussions with CareSource at this time. CareSource members can still come here for care as they do today.

The clinic’s statement added, “While we hope this does get resolved, in the event this relationship ends, patients may select another Medicaid plan to access Cleveland Clinic which can be done through the Ohio Medicaid Consumer Hotline. In addition, we will work with CareSource to provide continuity of care for patients, and as always Cleveland Clinic’s emergency departments are available regardless of insurance coverage or ability to pay.”

“We continue to meet and dialogue with the Cleveland Clinic,” CareSource said in a statement issued last month on the situation. “Our hope is for an agreement and resolution on behalf of CareSource members who receive their quality health care.”

CareSource, a nonprofit Medicaid managed care provider and commercial health insurer, is one of Dayton’s fastest-growing companies. The membership in its health plans has grown to more than 1.5 million.

Late last month, Cleveland Clinic had said it had received notice from CareSource that the Dayton company may terminate its relationship.

“CareSource members can still come here for care as they do today,” the clinic said in June. “In the event this relationship ends, patients may need to select another Medicaid plan to access Cleveland Clinic.”

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