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The deadline is here: Tenet's outpatient facilities will go out of network if Cigna contract expires

With their contract set to expire Dec. 31, Dallas-based Tenet Healthcare and insurer Cigna have been exchanging blows, the Telegram & Gazette reports.

Here's what you should know:

1. The two have been in negotiations since February. Cigna claims Tenet has been buying outpatient surgery centers and then doubling procedure prices. Tenet Spokesperson Lesley Bogdanow told the Telegram & Gazette the company wants to be paid fairly for services it provides.

"We are committed to providing compassionate care to the families in Worcester, Framingham and Natick [all in Massachusetts], and we employ over 5,000 men and women in the area through our hospitals and outpatient centers," Ms. Bogdanow told the Telegram & Gazette. "We have been negotiating in good faith with Cigna for close to a year to find the right solution that would allow us to meet the needs of these communities, but Cigna has repeatedly made unreasonable demands."

2. Cigna is seeking local, market-specific agreements with Tenet, but Tenet won't work with Cigna in Massachusetts until Cigna agrees on a national contract, Cigna representative Mark Slitt told the Telegram & Gazette.

3. If Tenet and Cigna don't reach an agreement, ARC Worcester Center — an ASC — will be out of network for Cigna commercial health plan members beginning Jan. 1, 2019. Other facilities affected include Worcester-based St. Vincent Hospital and Northboro, Mass.-based MedPost Urgent Care.

4. Tenet has been criticizing Cigna with advertisements in the Telegram & Gazette that read, "If you have Cigna, you have health unsureance."

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