Dispute may force Aetna patients to find new doctors

Published: Thursday, October 03, 2013 @ 9:57 AM
Updated: Thursday, October 03, 2013 @ 2:10 PM

The Kettering Physician Network recently mailed a letter to Aetna customers giving an update on its contractual relationship with the insurance company because of a dispute over reimbursement payments.

KPN Chief Medical Officer Dr. David Doucette says in the Sept. 25, letter that for an extended period of time, KPN has been in discussions with Aetna regarding new contract terms, specifically . The current contract expires Dec. 1. KPN has more than 250 doctors who operate in more than 70 locations between Dayton and Cincinnati.

If new terms are not reached by that date, KPN physicians will be considered out of network, Doucette says in the letter.

"This would mean that you can continue to receive care from Kettering Physician Network physicians, but may experience reduced benefits from Aetna," he says. But he adds they "hope to reach an agreement in the near future."

Aetna officials could not be immediately reached for comment.

Doucette says KPN has been working "for an extended period of time" with Aetna on a new contract and without a resolution. "We find ourselves in this situation very reluctantly," he says.

He notes the issue has over reimbursement."Our request of Aetna is to be reimbursed fairly for services delivered to our patients," he writes.

This marks the second time in a year that Aetna has been unable to reach a new contract agreement with a Miami Valley private physicians group. In October 2012, PriMed Physicians, which serves about 100,000 patients in the region, announced it was no longer part of Aetna's physician network because of a dispute over reimbursement payments. The decision impacted about 4,800 of its patients who were with the insurer. The two parties have yet to reach an agreement, forcing many patients to find new doctors.

At the time, an Aetna spokesman said the two parties have been in negotiations since January 2012, and that PriMed notified them in April they were terminating the contract.

"PriMed is seeking double-digit increases that are unaffordable in today's economy," Aetna spokesman Scot Roskelley wrote in an e-mail reply. "If we were to accept their increase request, it would put them way above the market average."

In Doucette's letter, he advises Aetna customers that KPN remains in-network with Aetna through Nov. 30.

Those currently being treated by a KPN specialty physician for on-going care of have scheduled treatment with a specialist from KPN after Dec. 1, "you may be able to continue to receive care from your physician by requesting approval for continuation with Aetna."

Doucette's letter also says "this does not affect Kettering Health Network hospitals participation with Aetna."

Customers with questions are advised to call their physician's office or KPN's customer service at (937) 531-0100.

Aetna has about 46,000 members in the Dayton region.

New restaurants, retail shops coming to Oxford

Published: Friday, October 28, 2016 @ 2:25 PM
Updated: Saturday, October 29, 2016 @ 4:37 PM

New restaurants and retail shops are coming to a development on the former Walmart site in Oxford.

Bishop Square — a 50,000-square-foot mixed use development at 419 Locust Street that currently includes 272 units of student housing — is adding Marco’s Pizza, Tim Hortons, a Sprint retail store and a bank.

“The final stage is important because we’ll be building the outlots that sit along Locust, which will serve as the front door to the whole project,” said Josh Rothstein, of Blue Ash-based OnSite Retail Group, which is handling marketing and leasing for the project. “The retailers and restaurants are excited to open their locations here because being across from Kroger, TJ Maxx and Dollar Tree provides tremendous exposure, great visibility and easy access to the shoppers already passing through this part of town.

“It’s also easily in walking distance to not only the concentration of Miami’s campus, but also the off-campus housing population,” Rothstein said.

Two other storefronts on the site are being are in the process of being leased, he said.

Existing Bishop Square tenants include Oxford Lane Library, Mercy Health - Orthopaedics and Sports Rehabilitation, Great Clips and Cloud 9 Vapor Lounge. A second-floor above some of those tenants includes office space.

Alan Kyger, Oxford’s economic development director, said the community is excited to see the Bishop Square project moving into its final phases.

“In 2005, when Walmart moved away from this site, the abandoned building that was left behind was a large eyesore for the Tollgate Business District, as well as for the whole community,” Kyger said. “Developer Robert Fiorita is to be commended in providing such a good-looking redevelopment project.

“The addition of these merchants will provide the citizens of Oxford additional shopping options. I expect each of these new businesses to be very successful in this new development.”

Marco’s Pizza has 700 stores in 35 states, doubling in size over the last five years and on track to 1,000 stores by the end of 2017, according to the company. Area locations include Middletown, Monroe, Hamilton and Liberty Twp. in Butler County.

Tim Hortons has more than 4,400 locations in the United States, Canada and the Middle East. Area locations include Monroe, Springboro and Maineville in Warren County.

Mother, 25, sent to prison in infant’s death

Published: Thursday, September 20, 2012 @ 5:11 PM
Updated: Thursday, September 20, 2012 @ 7:06 PM

A 25-year-old mother convicted of involuntary manslaughter and child endangering in the 2009 death of her 6-month-old son was sentenced Thursday to three years in prison.

Amber Gipson was convicted on Sept. 4 on single counts of each crime, the Montgomery County Prosecutor’s Office said.

Her son was found dead July 29, 2009, in a laundry basket beside a bed in which she was sleeping, according to police. Toxicology tests found cocaine in the blood streams of Gipson, who was 23 at the time, and the baby.

The county coroner ruled the cause of death as positional asphyxia.

“This mother utterly failed to protect her child from harm,” Heck said. “Parents have a responsibility to care for their children and cannot do that when they are high on cocaine, as this mother was.”

According to court records, Gipson has a long arrest record, including for prostitution-related offenses. In 2005, she served six months for grand theft auto. In 2006, she served six months for drug trafficking in crack cocaine.

Springfield stabbing suspect pleads not guilty

Published: Tuesday, July 17, 2012 @ 12:38 PM
Updated: Wednesday, July 18, 2012 @ 11:28 AM

A man accused of stabbing another man to death with a serving fork Tuesday morning plead not guilty to murder in a court appearance today.

Laune P. Dozier, Jr. also plead not guilty to an unrelated charge of aggravated robbery. His bond was set at $1 million.

Dozier was taken into custody by Springfield Special Operations Team officers Tuesday afternoon after a two-and-a-half hour standoff.

After firing several smoke devices into the building at 730 East St. and ordering a man to come outside, SOT officers escorted Dozier to a police van just after 2:30 p.m.

He was wanted in the fatal stabbing of Jason Wones early Tuesday morning at 338 Lincoln Park Circle. A warrant was issued for Dozier on a charge of murder Tuesday morning, according to Clark County Municipal Court records.

According to the warrant affidavit, Dozier, 19, was among a group of people drinking at the Lincoln Park address overnight. Witnesses reported that he began assaulting a female just before 7 a.m. and Wones attempted to intervene.

Dozier allegedly grabbed a two-prong serving fork from the kitchen and began stabbing Wones, who attempted to defend himself. At some point he was stabbed in the left side of his chest, according to the affidavit.

Dozier allegedly fled on foot before the witnesses called 911. Medics transported Wones to Springfield Regional Medical Center where he was pronounced dead.

SOT officers had been staged at the corner of East and Essex streets since about noon Tuesday. It is unclear what Dozier’s connection to that address is. His listed address on court documents is nearby on East Liberty Street.

East Street was shut down between Selma and Summer streets during the standoff.

Britanie Jackson lives on the other side of the duplex on East Street. She told News Center 7 she is not aware of any criminal activity going on there and that the building is “normally pretty peaceful.”

She said she was surprised earlier today when she attempted to walk home and found police had the street blocked and would not allow her to go to her house.

Man on scooter injured in Troy crash

Published: Tuesday, July 17, 2012 @ 11:53 AM
Updated: Tuesday, July 17, 2012 @ 11:53 AM

Police in Troy said a driver is expected to be cited in a crash that injured a man riding a motor scooter.

The crash happened on South Short and Race streets in Troy Tuesday morning, according to reports.  Robert Dunfee, 70, of Troy, lost control of his scooter while attempting to avoid a collision with a car making a left hand turn in front of  him.

Dunfee has only had the scooter since July 12. He was taken to Upper Valley Medical Center near Troy for treatment of road rash.

The driver of the car is expected to be cited for being left of center, police said.