Tuesday, November 24, 2009

JACKSONVILLE, Fla. – An 11th hour meeting between Blue Cross Blue Shield (BCBS) of Florida and industry stakeholders on Oct. 19 failed to dissuade the insurer from terminating hundreds of provider contracts Nov. 1.

“They are not going to change unless forced to do so,” said Sean Schwinghammer, executive director of the Florida Alliance of Home Care Services (FAHCS), who attended the meeting. “This was a business decision for them, but the program itself is in jeopardy if they don’t adhere to good business practice.”

BCBS, one of the state’s largest insurers, used a closed bid process to shrink its provider network from an estimated several hundred to about 15 for the entire state. Most providers received notification in July that they would lose their contracts.

By mid-October, many providers still hadn’t received official termination notices from BCBS and were confused about where and how to transfer patients.

“BCBS said it was up to us to notify the patients,” said Carl Wallman, president of Fort Lauderdale-based Galaxy Medical.

Although Wallman can no longer bill BCBS, he learned he would be unable to pick up his equipment from patients before mid-November.

While many providers believe BCBS’s move will affect patient care, provider Jose Linares, a contract winner, disagreed.

“We are more under the microscope, which is going to force us to perform at a higher standard,” said Linares, vice president of Miami Lakes-based All-Med Services of Florida. “We will be able to offer the same service and most patients won’t notice a change in provider.”

FAHCS planned to continue seeking a program delay or other alternative.

“Senators and representatives are calling me to ask me about this because they are hearing from constituents who are outraged,” said Schwinghammer. “If we are getting calls from the government, I am sure BCBS will be getting calls soon enough.”