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A resolution conveying the Metropolitan Council's request that Vanderbilt University Medical Center and Humana, Inc. resolve their dispute regarding reimbursement rates expediently and in such manner as to maintain current services for all Metropolitan Government employees, retirees, and pensioners, and others throughout Davidson County, without disruption.
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WHEREAS, Vanderbilt University Medical Center is the largest comprehensive research, teaching, and patient care health system in the Mid-South area, with over 1,700 licensed hospital beds across seven hospitals that sees more than three million patient visits per year; and
WHEREAS, Humana, Inc. is a for-profit American health insurance company based in Louisville, Kentucky. In 2021, the company ranked 41 on the Fortune 500 list and has been rated as the third largest health insurance provider in the nation; and
WHEREAS, on January 9, 2023, the Employee Benefit Board for the Metropolitan Government of Nashville and Davidson County was informed that Vanderbilt University Medical Center (VUMC) had notified Humana, Inc. that as of April 1, 2023, VUMC will no longer participate in Humana Medicare Advantage plans (Group and Individual) and Commercial Group plans as the result of reimbursement rate disputes; and
WHEREAS, VUMC is engaged as a significant provider in most network health care plans for Metropolitan Government employees, retirees, and pensioners; and all Metropolitan Government pensioners post-65 are enrolled in the Humana Medicare Advantage Plan; and
WHEREAS, any decision to terminate participation in the Humana Medicare Advantage Plans could pose sudden, drastic, and potentially harmful consequences for the valued pensioners and dependents within the Metropolitan Government. Additionally, termination could pose significant consequences for beneficiaries throughout Davidson County who are age 65 and over and who rely upon Humana Medicare Advantage for healthcare services; and
WHEREAS, ...
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