Cigna and Tenet Healthcare Strike Agreement for Coverage Continuity
As the close of 2025 approached, Tenet Healthcare and Cigna faced the potential for significant disruption, with 13,000 Palm Beach County insurance policyholders at risk of losing coverage at major hospital facilities. In a critical development, the two entities reached an agreement just before their existing contract expired. This accord ensures that Cigna members maintain access to Tenet Healthcare services, preventing any uptick in out-of-pocket expenses and safeguarding their patient-doctor relationships.
The negotiation process delved into crucial aspects such as reimbursement structures and coverage continuity, impacting accessibility across 57 additional Tenet hospitals and various outpatient centers nationwide. Prior to reaching the agreement, public disputes emerged, centering on Tenet's claims about Cigna's alleged use of AI-driven prior authorization delays. While Cigna refuted these claims, the specifics of the contract, including the duration and resolution of the disputes over AI allegations and reimbursement rates, remained undisclosed as of December 31.
Andrew Loftholm, representing the Palm Beach Health Network, part of Tenet, stated, "Tenet and Cigna have reached a new agreement that maintains full in-network access for Cigna commercial plan members to our health system." He underscored their commitment to regulatory compliance requirements and maintaining patient care access, with acknowledgment of community and employer support in preserving choice within the network. Meanwhile, Cigna released a statement outlining their collaborative efforts to enhance health outcomes by ensuring affordable care within the community.
Despite this productive resolution, the insurance industry landscape continues to face challenges. Unresolved negotiations in the provider-payer paradigm may cause insurance coverage lapses for nonemergency care in 2026, despite policyholders meeting their premium obligations. These tensions stem from rising healthcare costs, evolving treatments, and anticipated reductions in federal support for low-income patient care, which complicate financial negotiations between healthcare providers and insurance firms, including underwriting practices and claims management.