Blue Cross Notifies Medi-Cal Beneficiaries of St. Agnes Hospital’s Threat to End Contract
Blue Cross of California sent letters to Medi-Cal beneficiaries and doctors in Fresno County notifying them of a Sept. 7 deadline for an agreement in contract negotiations between Blue Cross and St. Agnes Medical Center and the possibility that the hospital might terminate its contract with the insurer to provide services to Medi-Cal beneficiaries, the Fresno Bee reports. According to the Bee, "several times in recent years" St. Agnes has said it would end its Medi-Cal contract with Blue Cross because of reimbursement disputes, but negotiators "managed to come to agreement close to deadline" in all previous cases. Blue Cross spokesperson Lisa Mee-Stephenson would not comment on the number of letters sent but said she was optimistic the contract would not be terminated. Blue Cross is required by law to notify affected doctors and Medi-Cal beneficiaries if a hospital might terminate its contract.
St. Agnes Chief Financial Officer David Singh said that in 2003, approximately 1,200 Medi-Cal beneficiaries were hospitalized at St. Agnes and about 14,000 beneficiaries received outpatient services at the hospital. According to Singh, the treatment of Medi-Cal beneficiaries has resulted in "significant losses" to St. Agnes. If the contract is terminated, Medi-Cal beneficiaries would not be denied treatment in the St. Agnes emergency department, but beneficiaries requiring hospital admission could be required to transfer to a facility with a Medi-Cal contract.
A St. Agnes official said the recent action is a part of the "normal negotiation process." Mee-Stephenson said, "We are currently negotiating and hope we will successfully come to an agreement as we have in the past." Singh said, "Blue Cross has about four to five times as many members in Fresno County. But that doesn't mean they all come to St. Agnes" (Correa, Fresno Bee, 7/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.