‘Impasse’ Between Blue Cross, Tri-City Medical Center Could Affect Access to Care for 19,000 Members
Blue Cross of California members may not have access to nonemergency services at Tri-City Medical Center if the two sides do not reach a contract agreement by June 1 -- a situation that could affect as many as 19,000 individuals, the San Diego Union-Tribune reports. The hospital and the health insurer agreed to reimbursement rates in February under a letter of agreement, but a Blue Cross spokesperson said that Tri-City "wants higher payments." As a result, Blue Cross plans to allow the letter of agreement -- which is not a contract and "generally says the health plan is leasing the services of the facility for a pre-determined rate" -- to expire at the end of May. Michael Chee, a Blue Cross spokesperson, said that the insurer has received a list of demands from Tri-City that "does not constitute negotiations. ... We've not sent letters to members. This is a private negotiation. The fact that [the public is] receiving this information is a negotiation ploy." Allen Coleman, vice president for business development at Tri-City, said the reimbursement rates included in the letter of agreement "were to cover the cost of care" in 2001. However, a new cost analysis found that the rates would not cover costs for 2002, he said, adding that without a "breakthrough in the impasse," Blue Cross members could not undergo elective procedures at Tri-City (Fong, San Diego Union Tribune, 5/7).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.