Providence Medical Associates (PMA) and L.A Care Health Plan end agreement effective April 30, 2025

April 28, 2024

Dear valued patient,

Despite Providence Medical Associates’ (PMA) best efforts to negotiate a new agreement in good faith with L.A. Care Health Plan, we were unable to reach acceptable terms.

This means effective May 1, 2025, our contracts with L.A. Care will end and PMA clinics will no longer be able to serve L.A. Care members in our clinics as an in-network option.

You should have or will soon be receiving a notice from L.A. Care announcing this news.

We understand this news is difficult for many of our physicians, providers and caregivers – and especially our patients. Please know that during the negotiation period, we exhausted every possible option, and we are also deeply saddened by this development.

Providence has endured multi-million dollar losses in its contract with L.A. Care due to poor reimbursement rates. Like many healthcare organizations across the country, Providence’s labor and supply expenses have increased significantly since the pandemic began, and we asked L.A. Care for a fair and equitable increase to our reimbursement.

Adequate compensation is imperative for continuing to provide competitive wages to our caregivers, who have been on the frontlines since before the pandemic, and for covering the rising cost of pharmaceuticals and supplies. Unfortunately, L.A. Care was unwilling to agree.

Providence strives to provide care for anyone who walks through our doors and our hospitals are able to continue serving L.A. Care patients. But on May 1, PMA providers will no longer be able to serve L.A. Care members in our clinics.

Please contact L.A. Care customer service at 1-888-839-9909 with questions about your new primary care provider or specialty care provider. In the meantime, if patients are pregnant or receiving active treatment for a chronic condition, they may qualify for “Continuity of Care” to continue seeing your Providence provider and should call L.A. Care to begin the process of applying.

We want to sincerely thank you for entrusting us with your care and are committed to supporting you during this transition. We are also available to support you in any transitions of your medical records.

Sincerely,

Providence Medical Associates (PMA)

March 24, 2025

Update Regarding Providence Medical Associates’ Negotiation with L.A. Care Health Plan

Dear valued patient,

We are writing to inform you that Providence Medical Associates (PMA) and L.A. Care Health Plan are in active negotiations to reach a long-term contractual agreement.

Patients with L.A. Care Health Plan may become out of network with their Providence, clinics and physicians if our contract is not renewed on April 30, 2025.

We know you rely on Providence to keep you and your family healthy. While we work hard to make care more accessible and affordable for everyone we serve, we face serious challenges. Like health systems across the country and in our community, we are experiencing rapidly rising costs of care caused by inflation, labor shortages, wage increases and supply disruption.

Contact negotiations enable us to make sure we are fairly paid for the care we provide. PMA has unfortunately endured significant losses in its contract with L.A. Care and are working with L.A. Care in a collaborative manner to ensure we can continue to provide high quality care for you and your family

• We are negotiating in good faith with L.A. Care to negotiate a fair and equitable contract. We hope to reach an agreement, in which case there will be no need for you to take any action.
• No action is required by you at this time, and you may continue to see your provider until April 30, 2025.
• Please contact L.A. Care customer service at 1-888-839-9909 for health plan coverage inquiries and to express your concerns directly.

Thank you for entrusting us with your care. We look forward to updating you soon. For up-to-date news and information regarding our negotiations, please visit: www.providencemedicalassociates.org.

Sincerely,
Providence Medical Associates (PMA)

Frequently Asked Questions

Q: Why is Providence Medical Associates (PMA) negotiating its agreement with L.A. Care?

A: Contact negotiations enable us to negotiate rates that pay us for the care we provide.  PMA has experienced significant losses in its contract with L.A. Care due to low reimbursement rates. Past rate proposals from L.A. Care do not cover the cost of serving L.A. Care’s members. Despite our best efforts, a beneficial outcome has not materialized.

Q: If an agreement is not reached, what is the effective date of the termination? 

A: If an agreement is not reached, patients can continue to see their PMA providers and clinics as an in-network option until April 30, 2025.

Q: Will I still have access to Providence hospitals?

A: Yes. This contract re-negotiation only applies to PMA providers and clinics. Patients can continue to access Providence hospitals.

Q: What if Providence is unable to reach a new agreement with L.A. Care? 

A: We want to reach a mutually beneficial agreement with L.A. Care. Our contracting team will negotiate in good faith to reach fair terms that reimburse us for the care we provide. If we are unable to reach an arrangement, we will work with our patients and let them know what their options are.

Q: What can patients do in the meantime?

A: No action is required by patients at this time, and they may continue to see their provider until April 30, 2025. As the termination date approaches, we will reach out to impacted patients who have appointments beyond April 30 to notify them.

Please contact L.A. Care customer service at 1-888-839-9909 for health plan coverage inquiries.

For up-to-date news and information regarding our negotiations, please visit: www.providencemedicalassociates.org