Blue Cross tells hundreds of providers to take a hike

Wednesday, September 30, 2009

JACKSONVILLE, Fla. - Providers across Florida received "Dear John" letters from Blue Cross Blue Shield (BCBS) on July 27 informing them their services would no longer be needed as of Nov. 1.

The Florida Alliance of Home Care Services (FAHCS) has been collecting information from providers to gauge the impact of the change, said Sean Schwinghammer, executive director.

"We are projecting it will be close to 300 (who lose their contracts)," he said. "It's substantial."

It appears the insurer, one of the state's largest, used a closed bid process to whittle down its network of providers to only 12 for the entire state.

Only about 30 large providers were invited to bid--most providers didn't' even know there was a bid, said Schwinghammer, who has talked to some of the bid winners and losers.

The bid covered all DME categories except complex rehab. It's bad news for both providers and beneficiaries, said Joan Cross, executive director of the Florida Association of Medical Equipment Services (FAMES).

"If you add this to what Medicare is doing with the oxygen cap and competitive bidding, how are these people going to stay in business," she said. "I'd like to speak with some of the bigger groups of (people insured under BCBS) and ask them: 'Do you want to have this little choice?'"

The letters invited providers to call with questions or concerns, but so far, said Schwinghammer, providers aren't getting any answers.

FAHCS and The VGM Group plan to  propose to BCBS grouping all terminated providers under VGM's managed care division, Homelink. The group would then match the bid winners' price and bill through one number.