A recent change in the provider network for Network Health/Commonwealth Care (NH/CC) has caused confusion for many Martha’s Vineyard residents enrolled in its health insurance plans.
As the result of a new contract, Partners HealthCare facilities no longer provide services to patients with NH/CC health insurance plans. The two exceptions, however, are Martha’s Vineyard Hospital and Nantucket Cottage Hospital.
Although both hospitals are Partners facilities, they will continue to accept NH/CC patients, according to letters from Network Health and Partners Healthcare sent to Vineyard Health Care Access ((VHCA) program director Sarah Kuh. She provided The Times with copies.
“I am writing to confirm that Network Health members with a PCP [primary care physician] of record on Martha’s Vineyard or Nantucket can receive services from any Partners Healthcare facility, including Massachusetts General Hospital, without prior authorization,” Network Health vice president Paul Burke wrote Ms. Kuh in a letter dated June 14.
Partners HealthCare sent a letter to healthcare providers that included similar information about the network change and examples of services patients may continue to receive from providers in the Partners system. Those include transfer to Spaulding Cape Cod or any other Partners hospital for care, and specialty care appointments at Massachusetts General Hospital.
Commonwealth Care is the general program name for the state’s affordable insurance for adults. What is somewhat confusing, Ms. Kuh said, is that Network Health has two different plans under different programs.
Network Health Forward is the name of its Commonwealth Care health plan. Network Health Together is the name of its MassHealth plan, which had no change in provider networks and does have a contract with Partners facilities.
“What has happened is that when some people receive a referral from any primary care physician or other providers on Martha’s Vineyard to any Partners facility, they are being told by specialists that they don’t take Network Health anymore,” Ms. Kuh said. “That’s because some of the physicians don’t know there is an exception for Martha’s Vineyard.”
For questions or more information, contact VHCA at 508-696-0020 or send e-mail to email@example.com.