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Health Department OKs Hold On Dropping Landmark From Blue Cross Network

Department grants request after BCBSRI agreed to tell physicians with admitting privileges only at Landmark that they wouldn't be penalized.

 

The RI Department of Health has granted Blue Cross and Blue Shield of Rhode Island’s (BCBSRI) request to suspend the process to remove Landmark Hospital from its coverage network.

The OK came with a caveat, though: First, Blue Cross had to agree to tell physicians with admitting privileges only at Landmark that they wouldn't be penalized. The company had notified physicians in July that it would require them to seek admitting privileges at another participating hospital.

“HEALTH recognized the difficult position that Landmark physicians faced in this situation,” said Michael Fine, MD, director of the RI Department of Health. “We requested that Blue Cross notify physicians that they are not required to have admitting privileges at a Blue Cross-participating hospital to remain as a participating Blue Cross provider. While we are now satisfied that this situation will not affect the relationship that patients have with their doctors in Woonsocket, we call on Blue Cross to move forward quickly in communicating this information to all Rhode Islanders.”

The process for Blue Cross to drop Landmark was set in motion prior to the insurance provider's Sept. 7 agreement with Landmark Medical Center ending the hospital's lawsuit against them and extending their coverage of services at the hospital three months following the closing of the sale of Landmark to Steward Healthcare.

The agreement between Landmark and Blue Cross is retroactive and extends the contract in place on July 17, 2012 until Dec. 31, or 90 days after closing on the sale of Landmark, whichever comes first. 

Following the agreement, Blue Cross Blue Shield asked the state to suspend its request to remove Landmark Hospital from its coverage network.

The Health Department has suspended the request for 60 days, effective Sept. 17.

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