By Linda Rawls, The Palm Beach Post, Fla. Knight Ridder/Tribune Business News
Dec. 28--Averting a major disruption in local health care, the state's largest insurer has signed an 11th-hour contract that keeps five local hospitals in its network, which insures 300,000 members from Miami to Vero Beach.
Blue Cross and Blue Shield of Florida announced Friday it had signed a one-year contract with HCA Inc.'s South Florida Division, which owns JFK Medical Center in Atlantis, Columbia Hospital in West Palm Beach, Palms West Hospital in West Palm Beach, Lawnwood Regional Medical Center in Fort Pierce and St. Lucie Medical Center in Port St. Lucie.
The agreement, effective Jan. 1, means members of all Blue Cross plans -- HMO, Medicare, preferred provider organization and traditional insurance policies -- will have coverage at these hospitals, Blue Cross senior consultant Mark Wright said Friday.
The current contract, which had been extended twice, expires Tuesday.
Blue Cross had sent letters to all its members warning it had been unable to reach an agreement with HCA, and that the five local hospitals would be dropped from its network if negotiations failed.
Had that happened, Blue Cross would not have paid for care at these hospitals for its HMO and Medicare policyholders, and its PPO and traditional policyholders would have paid much higher out-of-pocket expenses.
Blue Cross and HCA declined Friday to disclose terms of the new agreement or to discuss what effect, if any, it might have on premiums and patient costs.
During contract negotiations, the carrier objected to patient charges at HCA's 13 South Florida hospitals, saying they were higher than other hospitals in the area.
HCA, on the other hand, said its hospitals needed to be reimbursed fairly for their services.
Both sides said Friday they are happy with the agreement.
'We are very pleased with the HCA agreement and happy that its facilities will continue to be strong providers in our networks,' said Kenneth Sellers, group vice president for Blue Cross' South Geographic Unit.
And Madelyn Passarella, vice president of marketing and physician services at JFK Medical Center, said, 'We're very happy that an agreement was reached.'
Health Options, the Blue Cross HMO plan, accounts for 11 percent of JFK's business, she said.
The Blue Cross/HCA dispute is the second major flap between hospitals and insurance companies to be settled recently.
Last month, Aetna Inc. and Tenet Healthcare Corp. agreed to a new contract that allows 60,000 Aetna members in Palm Beach County to continue using Tenet's South Florida hospitals, which include five in Palm Beach County.
Another dispute remains unresolved.
Martin Memorial Medical Center in Stuart has ended its relationship with America's Health Choice, a Medicare HMO, effective Jan. 14.
The hospital said America's Health Choice didn't have enough specialists in its network to provide adequate care for its members. Health Choice is fighting to renew the contract.
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(c) 2002, The Palm Beach Post, Fla. Distributed by Knight Ridder/Tribune Business News.
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