Update: Georgia governor announces ‘handshake’ agreement between Piedmont Healthcare and BCBS

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Update 4/18/2018

Georgia Governor Nathan Deal announced late Tuesday that a ‘handshake’ agreement had been reached between Piedmont Healthcare and Blue Cross Blue Shield of Georgia. He announced on the governor’s Facebook page that announcement of an agreement in the form of a contract will be made as soon as possible by the contracting parties.

“This deal ensures no interruption of coverage for Georgians using Piedmont Healthcare as a provider during the contract dispute,” the governor announced on the Facebook page. Piedmont Walton had not yet been affected by the impasse and the governor had taken steps at the beginning of the month when the contract expired to cover those caught in the crossfire while negotiations continued.

Initial story

As Clearview Regional Medical Center officially became Piedmont Walton on April 1, Blue Cross Blue Shield patients had to contend with a problem between Piedmont Healthcare and the insurance company due to a breakdown in contract negotiations. As a recent acquisition, however, Piedmont Walton is not affected by the impasse at the moment.

Matt Gove, senior consumer officer for Piedmont Healthcare, said negotiations are ongoing, but couldn’t say when any resolution could be reached.

“We are still trying to negotiate-  still advocating on behalf of our patients to get a deal done with Blue Cross Anthem. The contract expired at midnight on Saturday and Anthem has taken Piedmont out of its network. “We are now in a position of trying to negotiate a new contract while we’re also trying to make sure our patients receive the care they expect and deserve and figuring out how to help them get through this if they’re out of network,” Gove said. “They don’t deserve to be caught up in this. What I can say is we continue to work as hard as we can to find a resolution and we hope that Anthem Blue Cross brings the same energy to the conversation so we can minimize the impact on our patients.”

Gove said that no patient should experience any issues in the case of an emergency. Emergency rooms are still covered.

With no resolution by Tuesday, Georgia Gov. Nathan Deal got involved, ordering the two parties back to the negotiating table and directing Blue Cross Blue Shield of Georgia and Piedmont Healthcare to return to negotiations on behalf of the nearly 600,000 employees, retirees and their families affected by the recent contract disruption. He also announced the state and the University System of Georgia would absorb out-of-network claims for affected employees for up to 30 days in order to minimize financial burdens placed on patients by the current stalemate between the parties.

“My administration will not sit idly by during this contract dispute and leave our state and university system employees, teachers and their families in the balance,” Deal said in a press release. “My top priority is the well-being of our members. Blue Cross Blue Shield of Georgia and Piedmont Healthcare must return to the negotiating table, and Blue Cross Blue Shield must honor the contractual obligations made to the state. If an equitable solution is not reached, I’ve directed the Department of Community Health and the State Health Benefit Plan to explore all possible solutions to ensure our members have access to care. The university system stands ready to take similar action on behalf of its employees. This step is necessary in order to protect our citizens from unanticipated costs and interruption to care.”

“We want to make sure University System of Georgia families have access to the care they need and this 30-day extension is a necessary step to provide coverage for our employees,” said University System of Georgia Chancellor Steve Wrigley. “Blue Cross Blue Shield of Georgia and Piedmont Healthcare must come to a quick resolution to this contract dispute so additional costs are not incurred by employees of the University System of Georgia and the state. We will continue to explore all options to ensure employees and their families have continued access to the healthcare they have been relying on through the University System of Georgia healthcare plans.”

In the meantime, Blue Cross Blue Shield and Piedmont have put out dueling press releases explaining their positions.

“We are disappointed that we have been unable to reach an agreement with Anthem Blue Cross for a renewed contract. We believed that both parties were negotiating in good-faith and had planned to reach an agreement by March 31. It didn’t become clear to us that Anthem Blue Cross didn’t share that goal until the end of negotiations. We were particularly disappointed that the written contracts from Anthem Blue Cross did not reflect the progress we thought we were making in our verbal conversations. That said, we remain fully committed to ensuring our patients have access to the care they need with the providers they trust. While Anthem Blue Cross has taken Piedmont out of its network, members can continue to see their Piedmont physicians, but in most cases will have a higher out-of-pocket costs. We know this is difficult for our patients, and we will do whatever we can to help our patients manage the impact of this disruption,” Piedmont wrote in a press release to its customer, going on to lay much of the cause for the breakdown in the low rates of reimbursement for services.

“People should be paid fairly for the good work they do. This is part of the fabric of our country and a core value we share with our communities. What Anthem Blue Cross is offering our doctors does not even cover the annual rate of inflation, but they will tell you that we are asking for unfair rate increases. One only needs to look at the small community hospitals – across Georgia and the country – that are closing their doors to see why fair rates are important. Piedmont strongly believes in the value of keeping care close to home and we will never stop fighting for that principle.”

BCBS put out information as well, noting that an agreement had not been reached and giving information for its customers.

“However, because we have not yet been able to reach an agreement with Piedmont (with the exception of Piedmont Rockdale Hospital and Piedmont Columbus Regional) is not an in-network health care provider with Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (collectively “BCBSGa”) effective April 1, 2018. This change includes doctors who are part of Piedmont Clinic and doctors who only admit to Piedmont Hospitals and do not have admitting privileges to another in-network hospital. Beginning April 1, 2018, all care provided by Piedmont will be considered out-of-network and reimbursed as out-of-network under the terms of your health plan.”

If you need more information, you can click or tap on this BCBS link for details on who is and who isn’t and what services are still covered at this time.

 

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