Gov. Deal directs Piedmont, Anthem back to negotiation table

- Georgia Gov. Nathan Deal weighed in Tuesday on the rift in negotiations between Piedmont Healthcare and Anthem Blue Cross Blue Shield urging both parties back to the table. A lack of agreement between the two could force thousands of patients across the state, including nearly 600,000 state employees, retirees and their families on the State Health Benefit Plan, to find new doctors.

Gov. Deal said Tuesday the state and the University System of Georgia will absorb any out-of-network claims for up to 30 days to help ease the impact and financial burden, but emphasized the two need to reach a long-term solution.

The governor released the following statement regarding the negotiations:

"My administration will not sit idly by during this contract dispute and leave our state and university system employees, teachers and their families in the balance. My top priority is the well-being of our members. Blue Cross Blue Shield of Georgia and Piedmont Healthcare must return to the negotiating table, and Blue Cross Blue Shield must honor the contractual obligations made to the state. If an equitable solution is not reached, I've directed the Department of Community Health and the State Health Benefit Plan to explore all possible solutions to ensure our members have access to care. The university system stands ready to take similar action on behalf of its employees. This step is necessary in order to protect our citizens from unanticipated costs and interruption to care."

University System of Georgia Chancellor Steve Wrigley echoed the governor’s concern for those employed in the system:

"We want to make sure University System of Georgia families have access to the care they need and this 30-day extension is a necessary step to provide coverage for our employees. Blue Cross Blue Shield of Georgia and Piedmont Healthcare must come to a quick resolution to this contract dispute so additional costs are not incurred by employees of the University System of Georgia and the state. We will continue to explore all options to ensure employees and their families have continued access to the healthcare they have been relying on through the University System of Georgia healthcare plans."

The two healthcare giants failed to reach an agreement before their contract ran out Sunday.  

“Despite our ongoing efforts, Blue Cross and Blue Shield of Georgia has been unable to reach a new agreement with Piedmont Healthcare that will keep them in our network of healthcare providers beginning on April 1," a representative for Anthem said in a statement to FOX 5.  "We apologize to our consumers for any disruption this may cause and we are working hard to reach an agreement that will bring Piedmont back into network as quickly as possible.  In the meantime, we are taking steps to help ensure our consumers have uninterrupted access to affordable healthcare across our broad network of providers in Georgia.  We urge consumers with questions about this network provider change to call us at the toll-free member services number on their Blue Cross and Blue Shield of Georgia ID card, or at bcbsga.com to view a list of providers in their area. Importantly, we want to remind our consumers that emergency care is always a covered benefit — anyone with a medical emergency should always call 911 or go to the nearest emergency department.”

The ongoing contract negotiations mean that most Piedmont Healthcare facilities and doctors will be considered "out-of-network" by BCBS.  

"While Anthem Blue Cross has taken Piedmont out of its network, members can continue to see their Piedmont physicians, but in most cases will have a higher out-of-pocket costs. We know this is difficult for our patients, and we will do whatever we can to help our patients manage the impact of this disruption," reads a statement on the Piedmont Healthcare website.  "People should be paid fairly for the good work they do. This is part of the fabric of our country and a core value we share with our communities. What Anthem Blue Cross is offering our doctors does not even cover the annual rate of inflation, but they will tell you that we are asking for unfair rate increases. One only needs to look at the small community hospitals – across Georgia and the country – that are closing their doors to see why fair rates are important. Piedmont strongly believes in the value of keeping care close to home and we will never stop fighting for that principle."  

According to Piedmont Healthcare, the hospitals affected include:
•    Piedmont Atlanta Hospital (including Piedmont West Ambulatory Service Center)
•    Piedmont Athens Regional
•    Piedmont Fayette Hospital
•    Piedmont Henry Hospital
•    Piedmont Mountainside Hospital
•    Piedmont Newnan Hospital
•    Piedmont Newton Hospital
•    Piedmont Clinic Physicians

Piedmont Rockdale Hospital and Piedmont Columbus Regional are not impacted.  

Some patients may qualify for "continuity of care," which would allow them to continue seeing Piedmont providers at in-network rates for certain conditions, including:
•    completing a course of treatment, such as cancer treatment
•    pregnancy
•    terminal illness or hospice care
•    transplant care
•    another serious medical or behavioral health condition

For more information on the negotiations, visit KeepPiedmont.org or bcbsga.com/Piedmont.   
 

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