HMO

Patient care to end over insurance impasse

You could be denied medical service at the facility of your choice based on the insurance plan your family can afford....

This is a case where the hospital and the insurance company were unable to reach a payment agreement. The hospital and insurance companies have mutually agreed not to do business with each other.
The patients in the hospital who are receiving treatment will have to leave before the deadline set in the agreement, although a clause has been left saying that those with the insurance can still receive emergency room services such as trauma or child birth. I think it's outrageous that you could be denied medical service at the facility of your choice based on the insurance plan your family can afford. This makes room for patient discrimination. Here's the article:

Temple University Health System's doctors are notifying patients that they've reached an impasse in contract negotiations with Keystone Mercy Health Plan.

The contract expires Aug. 31. "Based on the expiration of these contracts, [Temple University Physicians] can no longer provide primary care, specialty care or hospital outpatient testing at Temple University Health System facilities for patients covered by Keystone Mercy," the university said in a written release this week.

Keystone Mercy is a Medicaid-managed care plan operated by Mercy Health System and Keystone First, a subsidiary of Independence Blue Cross.

Keystone Mercy subscribers will still be able to receive emergency care and treatment for ongoing health conditions, such as pregnancy or chronic illness.

The contract dispute involves about 350 physicians and the health plan. The contract expired on Dec. 31, 2007 and it has been extended four times.

Temple estimates that nearly 12,000 patients are affected by the contract problems. It says the doctors receive $8 million a year from Keystone Mercy - $12 million less than it costs to provide care to the company's subscribers.

The health system itself has extended its contract with Keystone Mercy until Nov. 30, according to Rick Buck, a Keystone spokesman.

"It is Keystone Mercy's intention to maintain its business relationship with Temple University Physicians and Temple University Health System," Buck said.

What are your thoughts on this issue? Let others know and join the conversation by commenting below. You could be denied medical service at the facility of your choice based on the insurance plan your family can afford.... ... more

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