State Health Plan Board of Trustees Takes Action to Ensure Continuity of Care

The North Carolina State Health Plan (Plan) Board of Trustees approved a resolution today to direct Plan staff to take necessary actions if Duke Health and Aetna are unable to come to an agreement to keep Duke in the Plan's network. The resolution ensures that every Plan member who relies on Duke for their health care needs will receive personalized assistance to find a new, high-quality provider.

"The disruption in people's lives that Duke is inflicting would be substantial," said State Treasurer Brad Briner. "We are not taking that lightly. The Plan has never had to adopt a resolution like this before, but we will do whatever it takes to ensure that our members have uninterrupted access to high-quality care while Duke continues to demand more, more, more."

With just 24 days until the contract runs out, the Plan's Board of Trustees deemed it necessary to put contingency plans into action. That includes direct and personalized outreach to all 22,000 members who have selected a Duke primary care provider and approximately 40,000 members who have filed a claim through Duke this year.

"My team will get to work immediately to ensure this outreach happens quickly," said Thomas Friedman, Executive Administrator of the State Health Plan. "After tough decisions by the Plan to get us on a sustainable financial path, taxpayers, members and other providers have done their part. Now, Duke's insistence on a raise could cause additional premium increases in 2027. We don't want that and know that our members don't either."

Of note, there are about 2,800 members of the Plan who use Duke Health for treatments that are protected under state law for continuity of care. In these cases, they can continue to see Duke on an in-network basis. However, you must get a continuity of care form- you can do by calling Aetna Health Concierge at 833-690-1037 (TTY: 711) for a Transition Coverage request form.

The Plan remains hopeful Duke Health will choose to continue to serve everyone - from our teachers to correctional officers - and not demand higher prices for doing so. In the meantime, we are ready to help make any transition as smooth as possible.

Click here to view the resolution.

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