Agreement with Vista Health Plan terminates, effective
Jan. 29, 2009

The agreement between PCN and Vista Healthplan will terminate on January 29, 2009. Please recall that Florida law and your Physician Participation Agreement with PCN requires that we (a) continue to provide services as required until the effective date of the termination, (b) provide continuation of care for members receiving active treatment on the termination effective date until the course of treatment is complete or until such time as that member’s care can be transitioned and (c) collect only the appropriate deductible, co-payment and / or co-insurance from members. An Amended Exhibit A or B and an Amended Exhibit C were mailed to your office on November 14th for your files. If you have any questions, please contact our office.

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Patient care for Citrus Health Care contract begins
Jan. 1, 2009

January 1st – Citrus Health Care is a licensed Medicare HMO in twelve Florida counties. The company was established in 2003 and contracted in 2008 with PCN for expansion into Marion County. Patient care under this contract will begin January 1st. Please visit the Health Plan Partners section of our website for additional information about this health plan.

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Preferred Care Partners patient care begins Jan. 1, 2009

Preferred Care Partners is a licensed Medicare HMO. They were initially licensed in two counties in Florida in 2002 and currently cover 24,500 members. Their contract with PC was executed in 2008 and patient care will begin January 1st. Please visit the Health Plan Partners section of our website for additional information about this health plan.

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Changes to Healthy Kids Contract Administration takes effect Oct. 1, 2008

(Gainesville, Fla) – Health Plan Administration for the state of Florida’s “Healthy Kids” contract is put out to bid every three years and there will be some changes starting October 1, 2008.

For the past several years (six plus), Vista Healthplan has held the Healthy Kids contract for all eleven counties within Physicians’ Care Network’s territory.  As of October 1, 2008, Vista Healthplan will NO LONGER administer the Healthy Kids contract in Bradford, Columbia, Dixie, Gilchrist, Levy, Marion or Suwannee Counties. 

Vista Healthplan WILL CONTINUE to administer the contract in Alachua, Hamilton, Lafayette and Union Counties and members will continue to participate via Physicians’ Care Network. 

On October 1, 2008, Blue Cross Blue Shield (BCBS) will administer Healthy Kids contracts for the following counties: Dixie, Gilchrist and Levy.
 
Also on October 1, 2008, United Health Plan (UHP) will administer Healthy Kids contracts for the following counties: Bradford, Columbia, Marion and
Suwannee.

Please note that the patient’s county of residence determines which health plan is responsible.  The county where the patient is treated does not determine which health plan is responsible. 

If you wish to continue to treat Healthy Kids patients from counties which will be administered by BCBS or United, we encourage you to contact them directly to verify your participation status.

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Changes to the MultiPlan Contract for PCN Members, takes effect May 1, 2008

(Gainesville, Fla) - Physicians’ Care Network (PCN) has amended its contract with MultiPlan to include PHCS, MultiPlan’s new business partner. As a result, if you are participating with MultiPlan through PCN, you agree to accept the names and logos on the Authorized Logos list below with the exception of ValuePoint.  Here are some key points:

- Participation in ValuePoint (a medical discount program) is not assumed – if you want to participate in this program, you must inform PCN.      
- Reimbursement for PHCS (as identified by the PHCS name or logo on the identification card) differs from reimbursement for MultiPlan, which is unchanged
- The effective date of this change is May 1, 2008.

PCN terminated Aetna’s and Cigna’s access to the PCN network via MultiPlan in August, 2005. These payors may not access the PCN contract rates. Please also recall that in order for the payor to access the contract rates, one of the logos below must be present on the patient’s identification card. 

While the agreement between PCN and MultiPlan supercedes any direct contract between a participating PCN provider and MultiPlan / PHCS, the staff at both PCN and MultiPlan/PHCS encourage you to consider limiting your participation to one contract to avoid confusion (i.e., either terminate your direct contract or terminate your participation via PCN).

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Physicians’ Care Network & Health First Network Create a New, Powerful Venture: Patient Care First Network

(Gainesville, Fla.) – Physicians’ Care Network and Pensacola-based Health First Network, both independent physician associations, recently formed a new joint venture, Patient Care First Network, which will provide as many as 33,000 members access to managed care Medicaid products for the first time.

It’s a win-win for the two companies because by coming together they are able to reach an audience that neither could have reached on their own.  Physicians’ Care Network brings to the table a reputable network of physicians with impressive coverage of an eleven county area.  Health First Network contributes extensive expertise and financial resources.

“This venture marks a strategic opportunity for us to join with another large, successful IPA and stretch our presence and impact across most of the northern tier of Florida,” said Robin Herr, President and CEO of Health First Network.

The new company, Patient Care First Network, will offer managed care Medicare and Medicaid products to eleven counties under the WellCare umbrella. Again, tens of thousands of people stand to gain because of increased choice and enhanced quality of care.

“We are excited about this partnership for many reasons, but first and foremost because it makes sense for patients,” said Kim Kauffman, Executive Director of Physicians’ Care Network. “Managed care emphasizes prevention, incorporates predictive modeling and disease management, and simply considers what’s in the best interest of each patient as a whole. It’s a proven, team-oriented, and cost-effective approach to health care,” she added.

In addition to continuing to serve in their current roles, Charles Brewer, Executive Director of Health First Network and Kauffman will serve as Secretary and President, respectively, of Patient Care First Network.

Physicians’ Care Network and Health First Network are each made up of about 550 physicians and are both governed by a Board of Directors which is comprised solely of physicians. Together, their history spans more than three decades. In forming Patient Care First Network, both organizations hold steadfast to improving the health care experience and quality of life of people throughout the counties they serve across north Florida.

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