Barnabas and Aetna hit an impasse two years ago but resolved it before the contract expired.
TRENTON -- Aetna, the second-largest health insurance company in New Jersey, notified 45,000 policy holders this month that unless contract negotiations improve soon with the state's largest hospital network, patients will have to pay a lot more to use these facilities.
The two-year contract between RWJBarnabas Health and Aetna will expire April 22, according to the March 17 letter the insurance carrier sent to people who had been treated at one of the chain's hospitals in the past year.
The disagreement is over reimbursement rates, Aetna spokesman Walter Cherniak Jr. said Monday.
RWJBarnabas, which includes 11 acute care hospitals, is asking for "a significant rate increase we do not believe can be supported in the market," he said. "We continue to hope we can find a place where we can agree."
If they can't reach an accord, policy holders would have to pay more expensive out-of-network rates or select another hospital.
Aetna and Barnabas reach deal to keep in-network coverage intact
The ripple effect includes doctors, Cherniak said. There are 1,267 doctors who hold admitting privileges exclusively at RWJBarnabas hospitals, he said. Patients who need hospital care would need to find another doctor if these physicians could not quickly obtain admitting privileges at other hospitals.
RWJ Barnabas Health's spokeswoman Ellen Greene, released a statement Monday acknowledging Aetna's letter, describing it as "routine communication that HMOs and insurers must send to participants 30 days before the contract expires."
"RWJBarnabas Health and Aetna continue to negotiate with the desire to create a new contractual agreement," Greene statement said. "It is our goal and expectation that a new agreement will be reached with Aetna before our current contract expires on April 22. Aetna patients can still receive services at all RWJBarnabas Health facilities as contract negotiations continue."
Aetna and Barnabas Health reached an impasse over contract negotiations two years ago, resulting in 18,000 Aetna policy holders receiving a letter warning of the possible termination. But the two sides inked a deal three days before the contract expired.
Since then, Barnabas Health completed a merger with the Robert Wood Johnson Health System last year. Their joint holdings include Clara Maass Medical Center in Belleville; Community Medical Center in Toms River; Jersey City Medical Center; Monmouth Medical Centers in Long Branch and Lakewood; Newark Beth Israel Medical Center in Newark; Saint Barnabas Medical Center in Livingston; Robert Wood Johnson's former hospitals in Somerville, Hamilton, Rahway and New Brunswick; and The Cancer Institute of New Jersey at Rutgers University.
Negotiations do not always end amicably.
Last year, CarePoint Hospitals in Hudson County and Horizon Blue Cross Blue Shield of New Jersey, the state's largest insurance carrier, did not reach an agreement and the contract lapsed. Three months later, CarePoint sued Horizon in federal court to collect $76 million unpaid and underpaid medical bills since June 2015, and to end the carrier's "intentional and unlawful pattern of drastically underpaying" for care.
Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.