Deal between Blue Cross Blue Shield, Medical Center falls apart

lmorris@macon.comMay 12, 2014 

A tentative agreement reached last month has fallen apart between health insurer Blue Cross Blue Shield and Central Georgia Health System, which includes The Medical Center of Central Georgia.

The insurance company and the health system have been negotiating a renewal of its contract for several months. That contact is now set to expire Thursday, according to a late-Monday news release from the hospital.

In March, the hospital announced its current contract with Blue Cross would end April 24. Then late that day, the two sides announced they had reached an agreement that would be finalized by April 30.

Central Georgia Health System includes The Medical Center of Central Georgia, The Medical Center of Peach County and the Central Georgia Rehabilitation Hospital. Beginning Thursday, those hospitals will continue to accept Blue Cross Blue Shield insurance but will do so as an out-of-network provider, according to the release.

In a statement, the chief financial officer for the health system put the blame at the feet of the insurance company.

“While it has been our strong desire to continue our partnership with Blue Cross Blue Shield in order to continue providing care for Blue Cross Blue Shield patients in our community, the lack of effort invested by Blue Cross, one of the state’s largest health insurers, toward good faith resolution has seriously jeopardized our agreement,” CFO Rhonda Perry said in the release. “Regrettably, unless Blue Cross Blue Shield provides an acceptable amendment, their actions have left us with no choice but to prepare to terminate our contract.”

Central Georgia Health Network CEO Steve Barry said in the release that “the proposed terms we have received from Blue Cross Blue Shield are very different from the principles to which we had agreed on April 24, putting both the hospitals and physician network in extremely unfavorable positions.”

A call center dedicated to address questions and concerns has been set up by the health care facilities at 478-633-8888.

Bert Kelly, director of communications with Blue Cross Blue Shield, said in an email late Monday that the insurance company is “continuing discussions” with the health system. Kelly said updates for members will be posted at www.bcbsga.com/networkstatus.

Alternative in-network hospitals in Middle Georgia are Coliseum Medical Centers and Coliseum Northside in Macon, Houston Medical Center in Warner Robins, Perry Hospital in Perry and Oconee Regional Medical Center in Milledgeville, according to the insurance company’s website.

“Our primary goal during contract negotiations is to ensure we are compensating providers fairly, while providing our members the best access to affordable health care,” according to a Blue Cross Blue Shield website statement regarding the negotiations. “We are committed to protecting our members from exceedingly high medical costs. For these reasons, we are working diligently to reach a mutually beneficial agreement with (Central Georgia Health System) at rates and contract terms that are reasonable, fair and affordable.”

To contact writer Linda S. Morris, call 744-4223.

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