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BlueCross grants MSHA extension

Madison Mathews • Apr 17, 2013 at 9:27 PM

Mountain States Health Alliance has been granted a 30-day extension to negotiate its contract with BlueCross BlueShield of Tennessee before the insurance provider terminates its network coverage at Mountain States facilities, officials confirmed Wednesday.

Tony Benton, vice president of communications for Mountain States, said BlueCross agreed Tuesday to give MSHA a 30-day extension that would continue through July 1.

Benton said Mountain States will accept the 30-day extension after initially asking for a 90-day extension last week while both companies continue negotiations.

“For us, we’re cautiously optimistic that this is a step in the right direction and hopeful that this will allow the appropriate amount of time to reach an agreement with as little disruption and impact to patients as possible,” Benton said.

Last week, BlueCross notified 26,500 members that its coverage at MSHA facilities will end June 1.

Facilities that will be affected if BlueCross leaves the network include Johnson City Medical Center, Franklin Woods Community Hospital, Indian Path Medical Center, Johnson County Community Hospital, Kingsport Ambulatory Surgery Center, Sycamore Shoals Hospital and a number of other facilities and services.

The point of contention between both companies centers around a proposed reduction in BlueCross reimbursement rates.

Representatives with Mountain States have said BlueCross is wanting to cut reimbursement rates at double digit rates, while the insurance provider contends the reduction is a single-digit percentage of the rate the company pays MSHA that is comparable to the reimbursement rate offered to health care providers in the area.

By accepting the extension offered by BlueCross, Benton said patients who are currently covered in-network will continue to be covered until July — hopefully allowing enough time for both companies to come to an agreement.

“We want to be able to negotiate in good faith and the extension will allow a little bit of additional time to make that occur,” Benton said.

If an agreement is not met and BlueCross does terminate its coverage at MSHA facilities in Tennessee, Benton said it would affect a “significant number” of patients who use the insurance provider.

“That’s why we’re really both working to find a way to reach an agreement and hope that we again can continue a partnership that will be able to provide care for their customers that we’ve been able to do for years and years and years,” he said.

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