St. Francis, BCBS Kansas May End Provider Coverage Agreement

TOPEKA, Kan. (WIBW) - Topeka's St. Francis Health Center and Blue Cross Blue Shield of Kansas are on track to part ways in a disagreement that affects hundreds of patients.

Their current contract to provide care expires December 31, 2012.

St. Francis says negotiations continue, but they say BCBS is grouping St. Francis with health care facilities outside their service area that provide fewer services in order to justify lower reimbursement rates.

Debbie Welle-Powell, St. Francis Vice President for Managed Care, says fair payments from insurance companies are critical.

"The rates Blue Cross is negotiating would have a significant impact on our ability to continue providing patients with high-value care," she said. "We just can't allow this."

In a statement on the situation on its web site, BCBS says it believes in reimbursing health care providers fairly, but "we must sometimes draw the line with providers to protect our members from increased cost. That is our responsibility."

BCBS cited its 2011 payments, saying premiums would have nearly doubled if not for its contracts with providers.

If no agreement is reached, starting January 1, 2013, St. Francis patients with Blue Cross Blue Shield of Kansas coverage will pay higher out of network costs, or they could switch insurance or health care providers.

Both organizations have web sites stating their cases and offering consumer information.

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