Dear Peach State Provider:

This letter is to advise you that effective November 28, 2009, Grady Health System (Grady) will no longer be participating in the Peach State Health Plan (Peach State) network. However, members may continue to receive services at Grady and with their Grady PCP through December 31, 2009. After several months of negotiations with Grady, we have been unable to reach an agreement regarding certain contractual provisions.

Our members and your patients are our first priority. Therefore, to ensure a smooth transition, Peach State and Grady are working closely to coordinate care for members that are in active treatment. Over the next two weeks, Peach State will contact those patients to develop transition of care plans. Please assist us by contacting our Case Management Department at 1-800-704-1483, if you have a patient(s) that you believe will need assistance with coordination of care.

Even though your Peach State patients may use Grady through December 31, 2009, we ask that you begin immediately referring your patients to alternative participating hospitals. Effective January 1, 2010, all Peach State patients must be admitted to alternative participating hospitals (refer to our Provider Directory at www.pshp.com) for a list of hospitals in our network). Additionally, you must obtain authorizations for any services performed at Grady except emergency room care, which does not require authorization (refer to your Provider Manual for guidance regarding notification of admission requirements).

 If you have questions regarding this change, please contact the Provider Solutions department at 1-866-874-0633.

 Sincerely,

Kevin Sears

Vice President, Network Management

Peach State Health Plan

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