Insurance issues: Blue Cross customers in Nevada County and statewide lose coverage at Dignity Health hospitals

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Patients at Sierra Nevada Memorial Hospital who are covered by Anthem Blue Cross will no longer receive benefits, after the hospital’s parent healthcare company terminated its contract with Blue Cross earlier this month.

Dignity Health, which owns or operates about 40 hospitals across California, including Grass Valley Hospital, said in an emailed statement that its contract with Blue Cross was formally terminated on July 16. The two healthcare giants were struggling to reach an agreement to renew their previous contract, according to a statement released last month by Blue Cross.

“Unfortunately, Anthem was unwilling to accept a new contract that would allow us to maintain the services our patients and communities depend on,” said Dignity Health. in a press release regarding the contractual dispute.



Almost all of California’s Dignity Health hospitals will no longer be networked with Blue Cross. Some selected hospitals will remain in network with the Blue Cross for the moment, with the facilities specified on the Dignity Health website.

Sierra Nevada Memorial Hospital is one of the hospitals affected by the termination of the contract. According to spokesperson Chad Burns, new patients admitted to Grass Valley hospital after July 16 will no longer be able to apply their Blue Cross insurance plans to cover health costs.



People who were already receiving care from Dignity Health before the contract was terminated on July 16 will still be able to apply their Blue Cross benefits to cover costs, Burns added.

Patient Provider Organization Plans (PPO), Health Maintenance Organization Plans (HMO), and Health Care Management Administrator (HMA) Plans, as well as virtually every other healthcare package will no longer be accessible to Blue Cross clients in Santé Dignité establishments.

Blue Cross acknowledged that reimbursable fees are likely to rise for its customers in areas affected by contract termination, in an announcement released last month as contract negotiations between the two entities were still ongoing.

“This termination of the hospital contract could affect the repayable obligations of most Anthem Blue Cross members who are enrolled in the PPO, EPO, HMO and POS benefit plans and receive care at Dignity Health,” Blue Cross said. .

NEGOTIATIONS

Blue Cross has also issued a statement to clients on July 1 in which he said contract negotiations were failing because Dignity Health had insisted on substantial rate increases in clients’ health plans, if a contract were to be renewed.

“Dignity… has now informed us that if we do not agree to substantial rate increases, it will leave our health plans, making care in hospitals, medical groups and Dignity clinics inaccessible to Anthem members… we cannot and will not accept excessive rates. increases that will make Dignity care even less affordable for those we serve, ”Blue Cross said in the statement.

Conversely, Dignity Health blamed Blue Cross for a failed contract renewal, saying the insurance company made demands during negotiations that “threatened” Dignity Health’s ability to provide care. quality to patients.

Make no mistake, Anthem’s proposal would threaten Dignity Health’s ability to keep emergency departments open, provide advanced clinical care, and retain our employees in California and Nevada. the statement read.

Dignity Health did not comment on Anthem’s proposal which it said derailed negotiations, and none of the healthcare organizations responded to a request for comment on the specific issues discussed during contract negotiations.

Approximately 8.3 million California residents are covered by Blue Cross, according to Covered California, an insurance agency based in Santa Rosa.

Stephen Wyer is a writer for The Union. He can be contacted at [email protected]


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