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Story Archives: Franciscan Missionaries opt not to renew Blue Cross contract
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Franciscan Missionaries opt not to renew Blue Cross contract
Beginning Feb. 1, local residents with Blue Cross and Blue Shield insurance will no longer have St. Francis Medical Center or St. Francis North as in-network providers, thus forcing most to seek hospital medical attention elsewhere.
On Monday, the Franciscan Missionaries of Our Lady Health System and Blue Cross and Blue Shield announced that after six-months of negotiations, the two groups were not able to reach new terms. One of the issues the groups couldn't agree on involved reimbursement rates. FMOL sought a more than 30 percent increase in rates paid for services provided for Blue Cross' insured, an individual close to the negotiations between Blue Cross and FMOL said.
The two-year contract between both parities will end on Jan. 31.
According to the correspondence from Blue Cross Blue Shield, the Franciscan Missionaries hospitals sought a "double-digit pay increase" from the insurance company for services rendered for the company's insured.
"FMOL has made the decision not to renew its contracts with us because we would not agree to its requests for a double-digit pay increase," Blue Cross' letter said. "As a not-for-profit mutual company owned by our policyholders, Blue Cross has an obligation and mission to provide affordable access to quality healthcare," the letter said.
Blue Cross and Blue Shield president and chief executive officer Gerry J. Barry said the insurance provider intends to "keep the door open for ongoing negotiations."
St. Francis' president and CEO Scott Wester responded Tuesday in a prepared statement, saying the Franciscan Missionaries of Our Lady Health System's proposed rates "are determined by what is reasonable to meet the rising costs of providing care."
"The Franciscan Missionaries of Our Lady Health System's position is that it must be paid for the services it renders. We regret the significant inconvenience this will have on many people in our community, notably the many employers who renewed their health plan contracts with Blue Cross and Blue Shield at the beginning of the year. We believe that these employers were not informed that the contract was in negotiation and could terminate Jan. 31 if no agreement could be reached," Wester said.
"We are all victims of the inadequacies of the current healthcare payment system. Cost shifting is the only method hospitals and physicians have for making up the difference between low government reimbursement (Medicare and Medicaid) as well as those who have no ability to pay and who seek care at our institutions. We intend to keep the lines of communication open in hopes that we can reach agreement and resume a contracting relationship."
Glenwood Regional Medical Center CEO Ron Elder said, "Hospitals across the nation work diligently everyday to negotiate with insurance companies. Every hospital has that right and St. Francis has chosen to negotiate in this manner. Glenwood fully intends to maintain its contract with Blue Cross Blue Shield of Louisiana and will continue to serve the communities that need our medical services."
In the meantime, Blue Cross plans to announce special transitional rules to ease any inconvenience to its customers, Barry said. This change also will affect customers of Blue Cross subsidiary HMO Louisiana, Inc. and it third-party administrator, Benefit Management Services.
Customers are encouraged to visit the Blue Cross and Blue Shield of Louisiana website at www.bcbsla.com or call Blue Cross at the number listed on their ID cards.
Blue Cross said that most members will still be able to use St. Francis facilities, but at reduced, non-network benefits. Those customers who use St. Francis facilities will be billed for this service. Typically, out-of-pocket costs are higher for patients who get medical treatment by doctors who are not in their insurance provider's network.
Other hospitals in the Franciscan Missionaries of Our Lady Health System include: Our Lady of the Lake Regional Medical Center, Baton Rouge; Tau Center for Chemical Dependency, Baton Rouge; Our Lady of Lourdes Regional Medical Center, Lafayette; St. Elizabeth Hospital, Gonzales; and Assumption Community Hospital, Napoleonville. |
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