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Mountain States Health and BlueCross in contract negotiations

BlueCross BlueShield (BCBS) Insurance Company and Mountain States Health Alliance (MSHA) have until the end of June to negotiate a reimbursement rate and enter into a new contract. Their decision could impact 26,500 people in Tennessee. BCBS’s insureds previously received notification their healthcare coverage with MSHA could end unless an agreement is reached. The facilities impacted are Johnson County Community Hospital, Johnson City Medical Center, Franklin Woods Community Hospital and Sycamore Shoals Hospital, among others.
According to MSHA, negotiations with BCBS began in December 2012. The insurance company is asking for double-digit payment reductions to MSHA. Mountain State’s requested a 90-day extension of the contract to allow more time to reach an agreement. BCBS granted a 30-day extension that will expire on June 30, 2013.  According to Shane O’Hare, Corporate Director of Communications and Marketing at MSHA, BCBS came with the 30-day extension and additionally asked for further reduction in rates. “We’re optimistic something can be worked out,” said O’Hare. BCBS has previously stated MSHA’s current reimbursement schedule is not parallel to other healthcare systems in the area and they are asking for a single percent reduction of the present reimbursement schedule.

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