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Blue Cross Blue Shield Texas vs. Memorial Hermann

Blue Cross Blue Shield Texas vs. Memorial Hermann

Blue Cross Blue Shield Texas and Memorial Hermann Health Systems have been in talks for almost a year negotiating to continue their contract.  It isn’t going well and the deadline is looming.

Should to the two health care giants not come to an agreement on reimbursement rates, members of Blue Cross Blue Shield Texas will not have access to Memorial Hermann physicians, health care providers or facilities at in-network rates. 

Blue Cross Blue Shield Texas spokesperson Margaret Jarvis told KTRH, “Blue Cross Blue Shield of Texas is focused on our commitment to manage medical cost increases, while at the same time providing access to quality, affordable health care benefits.”

BCBST has been notifying members of the potential change in policy, as they are required to do.  Jarvis says members can get information about the negotiations at www.bcbstx.com/mhhs

Memorial Hermann supplied KTRH with a with a copy of their latest statement which read in part, “Memorial Hermann has worked very hard over the past years to create high quality, cost effective care for our patients,  We are a recognized national leader in clinically integrated care. Therefore, any agreement with BCBSTX must embrace our clinically integrated care structure and provide appropriate reimbursement for our services.  Memorial Hermann is hopeful that we will be able to come to terms with BCBSTX.  However, if we are unsuccessful in reaching a mutually acceptable agreement, Memorial Hermann hospitals, surgery centers, and ancillary locations will no longer be included in the BCBSTX network, effective July 1st.”

Andy Adams is Vice President and General Counsel of Adams Legal Services and says things aren’t looking good for a compromise.  “If this had happened five or six year earlier, I would have said this is all a big show and they’ll ultimately come to an agreement, but I think this will probably be in effect for quite a while.”

The deadline is midnight on Sunday.

 

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