News

Dec 10, 2009 11:20 AM by Press Release

UPDATE: Our Lady Health System And Blue Cross and Blue Shield

Statement from Blue Cross and Blue Shield of Louisiana:

Baton Rouge, La. - The Franciscan Missionaries of Our Lady (FMOL) Health System has made the decision not to renew its contracts with Blue Cross and Blue Shield of Louisiana. Effective Feb. 1, 2010, the FMOL System's hospitals and certain affiliated providers will no longer be contracted as in-network providers for the state's largest health insurer.

"Regrettably, the FMOL System has chosen not to renew its agreement with Blue Cross and to leave our networks," said Mike Reitz, Blue Cross president and CEO. "The amount they requested to renew their contract was unjustifiable. We have a responsibility to our members to manage costs, and we take this very seriously."

FMOL's decision not to renew its contract also affects the customers of Blue Cross subsidiaries HMO Louisiana, Inc., and Benefit Management Services.

FMOL hospitals that will no longer be in the Blue Cross network include:
Our Lady of the Lake Regional Medical Center, Baton Rouge
The Tau Center of Baton Rouge, Baton Rouge
St. Elizabeth Hospital, Gonzales
Our Lady of Lourdes Regional Medical Center, Lafayette
Heart Hospital of Lafayette, Lafayette
St. Francis, Monroe (both campuses)
Assumption Community Hospital, Napoleonville

The hospital chain's decision also affects certain physicians, facilities and other providers affiliated with FMOL whose contracts will expire as well. Blue Cross will send letters to its customers who currently see these physicians explaining how they are affected. The company continues to contract with a broad network of other quality hospitals, physicians and ancillary providers who can serve its customers' needs.

"We want to reassure our customers that we will make this transition as smooth as possible," said Reitz. "Our customer service representatives are here to help our affected customers find another network doctor or facility."

Anyone who has questions may call the Customer Service number on his or her ID card. Blue Cross also has set up a special page about the FMOL network changes on its website at www.bcbsla.com. This site includes updates and other information to help customers during this transition period.

The two organizations have been in negotiations for six months but were unable to reach new terms. "Blue Cross recognizes the impact this has on many people," Reitz said. "We sincerely regret that FMOL made this decision."

Reitz added, "Our door is always open to FMOL, and we will welcome them back into the network if they choose to accept our offer. We recognize the value they bring to our provider networks."

Most Blue Cross members will still be able to go to the affected FMOL facilities for services, but at reduced, non-network benefits. Special rules apply for services that are not available elsewhere in the community. In the case of an emergency, individuals should always go to the nearest hospital.

 

Our Lady of Lourdes has this to say:

The CEOs of FMOL Health System and Blue Cross met just this morning. We were awaiting response from Blue Cross to our offer of mediation to prevent this type of public disagreement. No one wins in these situations, especially our patients and community. We are extremely disappointed that Blue Cross has chosen to misrepresent the situation and facts. Franciscan Missionaries of Our Lady Health System remains in negotiations with Blue Cross Blue Shield.

 

Blue Cross has offered zero percent increase to us and our doctors saying there is no justification for any increase. We asked Blue Cross for a single digit increase to reimbursement rates – a modest adjustment. Our proposal assured that benefits from our pricing went to patients and businesses rather than the insurance company. Blue Cross has already raised premiums to its members which include this pricing without any rate increase to FMOL Health System providers.

 

Blue Cross further justifies their zero increase by saying our mission is a “luxury” and not worth consideration in paying us fairly. According to Blue Cross, our service to those most in need—care for children, trauma services, persons with mental health challenges, persons with AIDS, screenings for early detection of cancer or heart disease, numerous community agencies and more are not their priorities. Our mission is essential for the communities we are privileged to serve.

Fair payments from Blue Cross ensure that we can sustain the vital level of care necessary to our patients and community. We remain hopeful that we will reach a new agreement before January 31 and are committed to working toward that outcome. In the meantime, Blue Cross patients can continue to receive care at our hospitals and physicians the same way they always have.

 

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