Saint Mary’s Regional Medical Center says it made the 'difficult' decision to terminate the contract with Prominence HealthFirst, and as of August 17, 2021, the hospital is out-of-network. 

It released this statement: 

This decision was necessary to ensure that all patients at Saint Mary’s continue to receive exceptional quality care. Saint Mary’s Regional Medical Center is nationally ranked among the top 5% of high-performing hospitals across the nation.

Unfortunately, Prominence HealthFirst failed its members by refusing to authorize medically necessary care, failing to timely pay for medically necessary services, failing to provide adequate access to post-acute care, and maintaining a consistently low CMS rating compared to other health plans in the community and across the nation.

This network change does not affect the hospital’s commitment to care for the community. All patients, regardless of insurance, can continue to receive emergency care at Saint Mary’s Regional Medical Center without additional cost due to the termination. Saint Mary’s Regional Medical Center has also repeatedly assured Prominence HealthFirst that the hospital will honor continuity of care services for all members. This network change also does not affect Saint Mary’s Medical Group, which remains in-network with Prominence HealthFirst.

Saint Mary’s Regional Medical Center remains in network with major health plans such as Aetna, Anthem, United, and Silver Summit which offer Medicare Advantage coverage. Saint Mary’s Health Network is proud of its exceptional staff, nurses and physicians, and has invested more than $30 million in the last three years to expand the hospital’s technology, modernize equipment, update infrastructure, and implement the EPIC EMR system.

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