We are providing the following information to alert you to a change that may affect Kaiser Permanente patients receiving care at UW Medicine entities and locations including:
- Harborview Medical Center
- UW Medical Center
- Valley Medical Center and clinics
- Valley Medical Group
- UW Neighborhood Clinics
- UW Physicians
- Services provided by UW Physicians at Seattle Cancer Care Alliance.
Please refer to this information when providing services or scheduling appointments for these patients.
Background
Our contracts with Kaiser Permanente for Commercial and Medicare Advantage services will expire on May 31, 2021 unless renewed. Despite beginning negotiations in November 2020, we have yet to reach agreement on renewal terms.
A majority of Kaiser Permanente patients seeking care in our system are patients requiring specialty services including organ transplantation, cancer and complex obstetric care. The complexity of this kind of care requires adequate reimbursement commensurate for the costs of this type of care.
Earlier this week, Kaiser sent letters to affected patients alerting them to the May 31 contract expiration and UW Medicine is sending a correspondence to these patients as well. Patients have already contacted our providers and staff about this potential change in coverage.
The following information will help you answer their questions:
The Kaiser Permanente contract with UW Medicine expires on May 31, 2021.
Unless renewal terms are agreed upon, effective June 1, 2021, individuals with Kaiser coverage (for Commercial and Medicare Advantage plans) will be considered “non-contracted” or “out-of-network” for services provided by and at the entities listed above.
UW Medicine values and wants to continue our relationship with our Kaiser Permanente patients and will continue to negotiate with Kaiser Permanente regarding contract renewal terms.
However, if an agreement is not reached, Kaiser members electing to receive services from UW Medicine after May 31, 2021 may be required to pay a larger out-of-pocket amount, possibly up to the entire bill.
A prior authorization from Kaiser Permanente for services after May 31, 2021 will not be a guarantee of payment if the contract with Kaiser Permanente expires on May 31, 2021. In such an event, the patient may be financially responsible for the bill, unless Kaiser Permanente has entered into an individual case arrangement for a patient’s case.
Clinic staff will need to instruct Kaiser Permanente patients to sign a “Notice of Non‐Coverage” and/or “Advance Beneficiary Notice” (in the case of Medicare Advantage patients) to indicate that they will accept financial responsibility for any services not covered by their insurance plan.
Professional fees will not be covered as “in-network” for UW Medicine locations or for professional services at the SCCA.
Referrals or transfers of Kaiser members should not be accepted by any UW Medicine practitioner or facility without first securing all necessary authorizations and assuring that an individual case agreement/contract to cover the applicable patient’s services has been established.
Kaiser Permanente patients should contact their Kaiser Permanente Health Plan (the number on their membership card) with any questions, including questions regarding authorization for new services that are being scheduled with UW Medicine on or after June 1, 2021.
For more information, please visit uwmedicine.org/kaiserpermanente and review our Frequently Asked Questions. Download FAQs.
We will continue to negotiate in good faith with Kaiser Permanente with the hope that we can reach a satisfactory agreement that will allow patients access to our services.
Thank you,
Lisa Brandenburg
President,
UW Medicine Hospitals & Clinics
Debra Gussin
Associate Vice President
Primary Care Services and Population Health
UW Medicine
Jacqueline Cabe
Chief Financial Officer
UW Medicine
Sommer Kleweno-Walley
Interim Chief Executive Officer
Harborview Medical Center
Timothy H. Dellit, MD
Chief Medical Officer, UW Medicine
President, UW Physicians
Jeannine Grinnell
Chief Financial Officer
Interim Chief Executive Officer
Valley Medical Center
Cindy Hecker
Chief Executive Officer
UW Medical Center
Read the update: Revised FAQs for Kaiser Permanente contract expiration.
