St. David’s (HCA), Blue Cross unable to agree on contract; millions of policyholders may be affected

[TexasTowelie]

Insured patients with Blue Cross and Blue Shield of Texas are in jeopardy of losing access to affordable and in-network health care at one of the major health systems in Central Texas and the doctors who work there.

Blue Cross and Blue Shield of Texas has been negotiating a contract for the past few months with the parent company of Austin’s St. David’s HealthCare, but, so far, an agreement has eluded them.

If the Hospital Corporation of America, St. David’s parent company, and Blue Cross cannot reach an agreement, then 4.9 million policyholders could be forced to pay higher costs if they want to get treatment at St. David’s. The lack of a contract also means limited choices for patients.

Although officials for the insurer and the provider say the dispute is purely contractual, others suggested that the Affordable Care Act, or “Obamacare,” is almost certainly a factor in the situation. The new law encourages insurers to offer low-cost plans to attract new customers, so some insurers might feel pressure to recoup costs elsewhere.

More at http://www.mystatesman.com/news/news/state-regional-govt-politics/st-davids-blue-cross-unable-to-agree-on-contract/nb25y/?icmp=statesman_internallink_invitationbox_apr2013_statesmanstubtomystatesmanpremium (subscription required).

[font color=green]Later in the article it stated that the impasse could have effects throughout 39 facilities in places such as Corpus Christi, the Dallas-Fort Worth area, Houston, El Paso, San Antonio and the Rio Grande Valley.[/font]

[Rstrstx]

1. We'll see

Blue Cross is the insurer for the UT system. By the way is the parent company of St David's the HCA? (the same HCA founded by Bill Frist's father)

[TexasTowelie]

2. Yes, it's the same company. nt

[DhhD]

3. The Squeeze is on. Who or what will get squeezed? Hopefully big salaries, and for sure, bonuses.

Money to the care of the people.

[white cloud]

4. For profit insurance

and CEO bonus of 100 million + Insurance will never work or help the middle or working class.

[DhhD]

5. Fast track to Medicaid because you do not qualify for one of the ACA Plans?

Ill and need to see a doctor but low income? Go to a hospital to get help? Simply apply to Medicare that you are too disabled to work or too ill to take care of normal living needs (application can be picked up at a hospital or you can apply on line there, at home or at a library). Within a few weeks Medicare sends you the Medicaid paperwork. Medicaid has to reply to Medicare within a short period of time. You must keep in contact with Medicare to ask when you will be seen by the determining doctors. Medicare pays the doctors not the State of Texas for the initial assessment. Federal will make sure that the State picks up its responsibility especially since the State of Texas turned down the The Patient Protection and Affordable Care Act Medicaid Exchange. Meanwhile, the hospital or provider can send the bill to the State Health and Human Services Office as allowed by the ACA even before Medicaid eligibility is determined. And ACA will bill the State for the evaluation as approved by the ACA. Texas is in line for a huge expense as its has assumed liability for all of its citizens. All of the above policy holders can go to a hospital to see a doctor and the hospital will simply send the bill to the State.

http://www.medicaid.gov/index.html

This site has the button for the new ACA healthcare market place.

http://www.hhs.gov/open/contacts/cms.html

This site is the US Health and Human Services site for overall service.