Tufts to break with Blue Cross

Boston Globe ^ | January 6, 2009 | Scott Allen and Jeffrey Krasner

[Lorianne]

Tufts Medical Center has begun warning thousands of patients that Tufts doctors will no longer accept Blue Cross Blue Shield HMO coverage after Jan. 31, asserting in a letter that the state's largest health insurer refuses to pay Tufts doctors at a "reasonable rate."

The medical center is asking its patients to contact Blue Cross directly to "express your frustration."

The unusual move carries enormous risks for Tufts as well as for patients, who may be faced with the difficult choice of changing insurance coverage or changing hospitals in the next few weeks. The last time a hospital took the drastic step of canceling a major insurance contract, in 2000, worried patients were caught in the middle and thousands switched insurance carriers so that they could stay with their doctors.

[Lorianne]

It slowly unravels.

[Philo1962]

Isn’t Tufts University the headquarters for homosexual “friendly” indoctrination of the Massachusetts public school system?

[RU88]

On a similar note, I have Blue Cross/Blue Shield HMO coverage and was told by my provider that they will no longer fully cover the University of Pennsylvania health network along with the Children's Hospital of Philadelphia (CHOP). Both of these are outstanding health institutions. It's going to get to the point that if you're not independently wealthy you'll be on Medicaid with the rest of the rabble because your insurance will not cover the cost of treatment.

[sergeantdave]

I’d guess that Blue Cross investigators are finding mountains of fraud in upbilling, overbilling, kick-backs. etc. and are refusing to pay the inflated bills, so the quacks at Tufts are trying to play hardball. Tufts will lose.

One of the fastest growing industries in health care are medical billing investigators and qui tam law firms. They uncover billions in hospital billing fraud every year.

[al_c]

Or it could be that the system is under contract negotiations with BCBS and are wanting to raise rates and BCBS doesn’t want to. That happens quite a bit.