Health First Health Plans to end relationship with OMNI Healthcare

Rockledge, FL (August 1, 2008) – Health First Health Plans (HFHP) announced it will terminate its provider agreement with OMNI Healthcare (OMNI), effective October 1, 2008. The termination was announced in letters sent to approximately 50 OMNI physicians, their patients and Brevard County employers.

"Through a misinterpretation of the payment provisions in their contract, OMNI is demanding fees far above local market rates,” said Dr. Peter Weiss, CEO of HFHP. This demand is not only unfair to the other network providers, but impairs HFHP’s ability to continue to provide affordable coverage to the residents of our community.”

"We regret having to end this relationship but we are hopeful that we can reach a mutually agreeable arrangement with the OMNI physicians in the near future," added Dr. Weiss.

HFHP customer service representatives will work closely with its health plan members to help them transition to new healthcare providers. “HFHP still maintains an expansive provider network and we are confident that the majority of affected members will be able to switch seamlessly to an alternate network provider,” said Dr. Weiss. "Our focus remains on providing excellent and affordable healthcare for our members."

For assistance in identifying a new primary care physician or specialist, HFHP members can speak with a customer service representative by calling (321) 434-5665 or (800) 716-7737 between 8 a.m. and 8 p.m. any day of the week or contact Customer Service online.

A note to our members

If you are actively undergoing treatment with an OMNI provider that won’t be completed by October 1, 2008, it is important that you plan for the upcoming change. Please work with your doctors to transition to a network provider, and contact us if we can help in any way. If you need to stay with your current doctor to complete a course of treatment after the effective date of this change, please have your doctor submit an authorization request to our Clinical Services Department at 434-4271.

• For Medicare members: If your current Primary Care Physician (PCP) and/or specialist is affiliated with OMNI, you will need to change to different network provider(s) for your covered care.  If you are actively undergoing treatment with an OMNI provider that won’t be completed by October 1, 2008 and continued care is authorized, it will be covered according to your in-network benefits.  If authorization is not obtained, you will be responsible for the entire cost of the out-of-network care. No referral is required by your plan to see network specialists.
• For commercial POS members: If your current Primary Care Physician (PCP) and/or specialist is affiliated with OMNI, you will need to change to different network provider(s) to receive your covered care at your in-network cost-share. If you are actively undergoing treatment with an OMNI provider that won’t be completed by October 1, 2008 and continued care is authorized, it will be covered according to your in-network benefits. If authorization is not obtained, your out-of-network benefits will apply. No referral is required by your plan to see specialists.
• For commercial HMO members: If your current Primary Care Physician (PCP) and/or specialist is affiliated with OMNI, you will need to change to different network provider(s) for your covered care. If you are actively undergoing treatment with an OMNI provider that won’t be completed by October 1, 2008 and continued care is authorized, it will be covered according to your in-network benefits. If authorization is not obtained, you will be responsible for the entire cost of the out-of-network care. No referral is required by your plan to see network specialists.

We apologize for any inconvenience this change causes you, and are here to help you make the smoothest possible transition. Please contact us for assistance.

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