Cigna and Randolph Health contract impasse causes coverage interruption

RALEIGH — Cigna insurance plan members received notification that they would no longer be covered at Randolph Health after February 10.

A letter from Cigna on “Continuity of Care” obtained by North State Journal indicates the insurer and Randolph Health have been unable to agree on a contract. 

Cigna’s letter informed members that if hospital stays were approved by February 10, their continued stay would still be covered. For medical care beyond that date, members would have to seek treatment at a different in-network provider. 

A list of in-network providers offered by Cigna includes Chatham Hospital, Cone Health Wesley Long Hospital, and Novant Health Kernersville. 

According to Cigna’s letter, members should check or use the Cigna app to find out more details on Continuity of Care or to talk to customer service. 

“Especially as our clients and customers are managing rising prices due to inflation, we want to keep their health care affordable and in line with other area providers,” a Cigna spokesperson wrote in an emailed statement to North State Journal. “Unfortunately, Randolph Health has notified us they will leave our network on February 10 unless we agree to their demand for unreasonably high rates that would impact employers, their employees, and their families.” 

“We hope that Randolph Health will do what is best for our shared customers, and we will continue to negotiate with them in good faith to reach a fair agreement,” the Cigna spokesperson wrote. “If they don’t, we are prepared to quickly help our customers find other quality, in-network providers nearby.”  

North State Journal also reached out to Randolph Health communications officer Paula Richards who responded with a press statement confirming a contractual agreement with Cigna had not been reached. 

According to the statement, Cigna has not given Randolph Health “is seeking an increase in reimbursements to help cover the tremendous rise in costs over the last decade for labor and other necessary costs of providing quality healthcare to this community.” 

The statement points out that Cigna has not given Randolph Health any reimbursement increases in almost 10 years.

“Randolph Health Over the last ten years, Cigna has seen an increase of 500% in its stock value, and its CEO receives a salary of approximately $20 million per year. It is because of insurance companies like this that community hospitals continue to go out of business,” the Randolph Health statement says. “Now, Cigna is threatening to severely restrict access to health care of Randolph County citizens who are Cigna members by forcing them to go out of network or change their doctors.”

Randolph Health’s statement says the hospital wants to continue to work with Cigna and hopes Cigna will “come to the table to work together to provide the necessary healthcare needed for Randolph County citizens.”  

“Our ER is open 24/7 to treat emergencies for Randolph County citizens, including Cigna customers,” reads the statement in closing. 

A request to the Randolph County manager for more information is still pending.

Randolph Health has struggled fiscally after taking out a bond worth over $49 million in 2007 to build new endoscopy and imaging facilities. 

In August 2020, Randolph County’s Commissioners worked to shore up Randolph Health with a $20 million investment for renovations following the Dava Foundation, a Tennessee nonprofit that had agreed to purchase the 145-bed hospital at that time. The $20 million was to come from the Rural Health Care Stabilization Act passed by state lawmakers in 2019 as part of that year’s policy and budget compromises.

In 2021, the Moore County Journal reported that the state of North Carolina would loan $12 million to aid in renovations to Randolph Health to be undertaken by its new owner American Healthcare Systems.

By A.P. Dillon