Landmark Caught In Middle Of National Insurance Reimbursement Struggle

Steward's deadline to buy hospital stretched as officials, court argue over rates.



Landmark officials claim low Blue Cross Blue Shield reimbursement rates sank the non-profit hospital, and renegotiating with Steward Healthcare's market power has failed, placing the institution on the losing end of both sides of a national struggle.   

Yesterday, Attorney General Peter Kilmartin extended Steward Healthcare's deadline for closing on the purchase of to Aug. 31 instead of waiving it as the hospital network requested.

Steward sought to waive the request outright, according to the Woonsocket Call. That request came Friday, on the last day of the prior extension, "So it's frustrating," said Amy Kempe, public information officer for Kilmartin's office.

The second extension coincides with a dispute between Steward Healthcare and Blue Cross Blue Shield over reimbursement rates for Landmark. The Providence Business News reports the BCBS contract with Landmark expired July 16, and the insurer has filed a modification plan with the Department of Health to stop coverage for the hospital. The Wall Street Journal began reporting a trend of insurers dropping providers over reimbursement disputes in 2010.

The Attorney General's office is reviewing a request by Mayor Leo Fontaine to look into the reimbursement negotiations between Blue Cross Blue Shield and Landmark for a possible anti-trust law violation.

But WRNI's healthcare blog, The Pulse, reports the FTC is actually looking into hospital mergers with the intent of preventing hospital groups like Steward from using their own monopoly power to boost reimbursement rates, with the effect of raising healthcare costs.

Meanwhile, Landmark is pursuing a suit of Blue Cross Blue Shield in Superior Court, claiming the insurer's reimbursement rates for the as-yet non-profit hospital contributed to its financial demise.

Not Leo Fontaine July 31, 2012 at 03:59 PM
I don't understand Leo's thought process,doesn't the City use it's monopoly power to raise tax rates?
RonW August 01, 2012 at 08:45 PM
John Ward Jr. August 01, 2012 at 08:52 PM
Another union bitching and complaining.


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