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Duke–Aetna Contract Standoff Puts NC State Employees’ Access at Risk by Oct. 20

The State Treasurer says meeting Duke’s reimbursement demands would drive another premium increase.

Overview

  • Talks between Aetna, administrator of the North Carolina State Health Plan, and Duke Health remain unresolved as the Oct. 20 contract deadline approaches.
  • If no agreement is reached, Duke would become out-of-network for roughly 743,000 public employees, retirees and dependents covered by the plan.
  • State Treasurer Brad Briner warns that agreeing to higher Duke rates would likely require additional premium hikes after this year’s increases.
  • Aetna has alerted Medicare-eligible retirees that Duke could leave its network, while Duke runs ads, letters and a website urging patients to pressure the insurer.
  • Duke says current rates lag care costs and that it serves fewer than 10% of plan participants, as Aetna pledges to curb cost growth and state law guarantees continuity of care for certain conditions.