Negotiations are underway to resolve a billing dispute between a large cancer treatment group and the health insurance provider for Clark County School District teachers, a rift that could otherwise lead to the medical group declining to accept educators as new patients over longstanding billing problems.
Comprehensive Cancer Centers of Nevada is in discussions with THT Health, a nonprofit health trust that insures about 34,000 people — licensed school district employees and their family members — and is overseen by the Clark County Education Association teachers union.
Comprehensive Cancer Centers of Nevada said in a statement Thursday it’s seeing patients in active treatment “as scheduled and without interruption.”
“For other contractual issues, our legal team is in active discussions with THT and we will provide an update as to the result of the negotiations,” the medical provider said.
Clark County Education Association Executive Director John Vellardita said in a Tuesday statement to the Review-Journal: “What has been represented to CCEA is that the parties are working through counsel toward the goal of an amicable agreement. Accordingly, CCEA’s expectation is that the issue between THT and Comprehensive Cancer Centers will be resolved.”
THT Health, formerly the Teachers Health Trust, said in a Thursday statement it’s committed to providing quality health insurance for educators and “continues to have an open dialogue with Comprehensive Cancer Centers of Nevada.”
“We are confident we will reach a mutual solution with Comprehensive Cancer Centers of Nevada that ensures continued care for existing and new Teachers Health Trust members,” the insurer said.
School district employees have voiced frustrations for months with THT Health, which is facing millions of dollars in debt. Some say medical providers have dropped them as patients because the insurer hasn’t paid past due claims or they’re receiving letters from providers threatening to send them to collections.
One employee’s experience
Yves Tremblay, who has stage four metastatic breast cancer, is a speech pathologist who has worked for about 28 years for the Clark County School District.
She said she received a letter dated Sept. 7 from Comprehensive Cancer Centers of Nevada stating that it will no longer be a participating provider for THT Health as of Sept. 20.
“We are saddened by this turn of events but have been forced by financial realities of THT to remove ourselves from its network,” the letter states.
It later clarified that existing patients with THT Health insurance would continue to receive care.
“As a Comprehensive patient, the continuation of your medical care is very important to us,” the medical group wrote. “Comprehensive will continue seeing existing THT patients.”
But those with THT Health insurance who haven’t established care at Comprehensive Cancer Centers of Nevada prior to the cutoff date will need to contact THT Health for a list of available providers, it said.
The cancer centers said the move was necessary because of foot-dragging by THT Health, which abruptly informed members it was in financial trouble again “many months after it was aware it could not pay providers,” the letter states.
“Comprehensive has continued to provide excellent care to its THT patients even though it has not received payments for more than seven months now,” the medical group wrote. “Further, THT has attempted to force Comprehensive to accept a reimbursement well below market, which does not cover the cost of care for its patients.”
Comprehensive Cancer Centers of Nevada will continue to work toward a resolution with THT Health, “but will only consider an agreement that is fair, reasonable and allows the practice to remain financially solvent,” the letter states.
Tremblay said it wasn’t initially clear to her about whether her insurance would continue to be accepted. But when she went to an appointment Thursday she was told she’d be able to continue receiving treatment.
Tremblay said she has had the same cancer treatment team for five years since she was diagnosed in 2016.
“I would really like to have my same cancer team because I love them,” she said, adding that they’ve kept her alive for the last five years. “They know me personally, they know me medically.”
When Tremblay walks in for an appointment, employees recognize her and know her name. And she has bought them Christmas presents.
Tremblay said the THT situation is not the school district’s fault. She said now that UMR has taken over administration of the health plan, a lot of claims are being paid and she hopes the situation will improve.
Despite a recent $35 million advance from the school district in May to the THT Health, the trust said in an August letter to medical providers it doesn’t have enough money to pay past due claims prior to July.
The health insurance trust had $43 million in debt as of February. It also recently hired a new leader, Tom Zumtobel, after its previous CEO Michael Skolnik resigned in May.
Legal and financial issues with the trust have spanned for years, and the trust previously received a $10 million bailout.
Earlier this month, THT Health held open enrollment and offered members two plans, which become effective Oct. 1, according to its website.
The School Board is scheduled to hear a presentation on Thursday with updates about the health trust.