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Nebraska Insurer Says Hospital Chain Overcharging

By: Nick Starling/ Associated Press Email
By: Nick Starling/ Associated Press Email

One of Nebraska's biggest health insurance firms is trying to force Catholic Health Initiatives to negotiate lower prices at its hospitals in the Omaha area.

Blue Cross Blue Shield of Nebraska said Tuesday it notified Catholic Health Initiatives that it plans to terminate its contract with the provider at the end of August if an agreement can't be reached.

The insurer says Alegent Creighton routinely charges more than other Omaha hospitals.

The contract covers all Alegent Creighton hospitals in Omaha, Schuyler, Plainview and Council Bluffs, Iowa. CHI is affiliated with 3,000+ Omaha-area providers, and owns several Nebraska hospitals, including:

• Alegent Creighton Health (Omaha, Council Bluffs, Schuyler, Plainview)
• Good Samaritan Hospital (Kearney)
• Nebraska Heart Hospital (Lincoln)
• Saint Elizabeth Regional Medical Center (Lincoln)
• Saint Francis Medical Center (Grand Island)
• St. Mary’s Community Hospital (Nebraska City)

"Today services at Alegent Creighton cost significantly more than others adding millions of dollars annually to the overall cost of care beyond what others accept for payment," said Lee Handke senior vice president of Blue Cross Blue Shield of Nebraska.

"We obviously dispute that based on our review not only our services but other offerings of our competitors of our various markets we thing we're absolutely in line," said Cliff Robertson, M.D., the C.E.O of Catholic Health Initiative's.

The 700,000 people insured by Blue Cross will be able to continue seeing doctors affiliated with the Catholic Health network at least through Aug. 31.

According to BCBS if an agreement is not reached by August 31st they will notify you in advance and provide necessary resources to ensure you have minimal disruption of care. If an agreement is not made, members with certain medical conditions will be eligible to receive in-network benefits for services received from their current physician for a specified period of time to help ease their transition of care.

Now there's some conditions that may qualify for continuity of care coverage, those include:
-Members currently undergoing surgical or non-surgical treatment for cancer.
-Members in the second or third trimester of pregnancy, or those considered to have a high-risk pregnancy.
-Members who had a recent bone marrow or organ transplant, or those on the waiting list to receive an organ.
-Members receiving in-patient services at a facility on August 31.
-Members currently receiving in-patient or out-patient treatment for mental illness and/or substance abuse by a licensed mental health provider.
-Members currently undergoing treatment for HIV and or AIDS.


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