A court fight is brewing between ProMedica and McLaren St. Luke’s Hospital in Maumee over the removal of Paramount insurance coverage.
McLaren St. Luke’s recently filed an antitrust lawsuit in U.S. District Court for the Northern District of Ohio to prevent a plan by ProMedica Health System to end Paramount commercial and health plan coverage Jan. 1 through the hospital and its physicians. McLaren St. Luke’s contends that its loss of coverage for Paramount health plans, which are affiliates of ProMedica, will prevent thousands of people from visiting their established doctors at the hospital and receiving non-urgent care at the hospitals or WellCare Physician Group locations.
St. Luke’s on Monclova Road is the hospital nearest Swanton and there is a St. Luke’s Physical Therapy location on Turtle Creek Circle in Swanton.
The Fulton County Health Center (FCHC) is not impacted.
According to Steve McCoy, FCHC director of marketing and planning, “Fulton County Health Center is not anticipating any changes with our current contract with Paramount Insurance.” McCoy said FCHC has no connection to the litigation between ProMedica and McLaren St. Luke’s.
The lawsuit claims that terminating Paramount insurance coverage at McLaren St. Luke’s will affect about 50% of the hospital’s overall area market share, and that ProMedica has gained an unfair advantage in the Toledo-area market. It accuses ProMedica of pulling Paramount’s eight individual contracts from St. Luke’s because the hospital’s new ownership by McLaren Health Care Corporation could threaten ProMedica’s area dominance.
“This challenge comes as McLaren St. Luke’s prepares to make significant investments that will allow our hospital to better serve the community with a broader range of services, which ultimately creates increased competition for ProMedica,” said Jennifer Montgomery, president and CEO of McLaren St. Luke’s. “By terminating McLaren St. Luke’s in-network provider status, ProMedica is penalizing their own members by limiting choice and causing,significant damage to our hospital.”
Promedica issued a statement saying it does not comment on pending litigation but will prove McLaren St. Luke’s complaint is frivolous.
Reach David J. Coehrs at 419-335-2010.