MEMPHIS, Tenn. — January 1 has come and gone, and so far there is still no deal in the stalled negotiations between insurer Blue Cross Blue Shield and Methodist Le Bonheur Healthcare.
Some families with children in Memphis hospitals say they’re already feeling effects.
WREG has reported extensively about negotiations between Blue Cross Blue Shield and the Methodist Le Bonheur Healthcare system, which includes Le Bonheur Children’s Hospital….so far the two have failed to reach a deal meaning families could see much higher costs, go without care or have to travel for care.
Shana Lowell’s son sees a lot of specialists for Crohn’s disease and visits Le Bonheur Children’s Hospital. He had bloodwork done at the end of last week, before the new year.
We’ve spoken to her about her concerns in the past as contract negotiations were underway. Now she wonders when the new billing will kick in — and it’s not just her son she worries about.
“These are children and there are critical windows for care very often,” Lowell said. “There are critical windows for my son that if it doesn’t happen in a certain time it could have lifelong effects.”
Sarah Marbry, a mom of four, called the situation “heartbreaking.”
“These are children in foster care and disabled children and low-income families, and it’s a big deal to have to go elsewhere for healthcare,” Marbry said. “It affects us tremendously. I have a 4-year-old daughter that has Down syndrome and every doctor that she sees is at Le Bonheur. “
Lowell says she’s privileged to be able to travel for care, even though it does present a burden but thinks of those who can’t.
“I drive several times a year to Cincinatti to do that. If we take Le Bonheur out of the picture, which has most specialists, I would imagine then how many more people are you leaving in a situation where they can’t get the care they need, that they have to go out of town if that’s even possible. We’re lucky, we have a car that can get me to Cincinatti.”
In a letter dated Dec. 16, Congressman Steve Cohen asked Tennessee Gov. Bill Lee for his assistance to resolve the contract dispute, citing the critical work of Le Bonheur Children’s Hospital and relationship with TennCare.
Marbry told us she spoke with Blue Cross Blue Shield Tuesday and a representative told her they could still potentially reach an agreement sometime during the year.
The state of Tennessee said through a spokesperson that ongoing negotiations between Blue Cross Blue Shield and Methodist Le Bonheur affect only TennCare members who have health care coverage through their health plans — BlueCare and TennCare Select.
“TennCare members who have health coverage through our other health plans will still be in-network with Methodist Le Bonheur,” said Amy Lawrence with the state, in an email.
“For those members who are affected, BlueCare is contractually required to ensure continuity of care for TennCare members. Members currently receiving care at a Methodist Le Bonheur facility can continue to receive those services for up to 90 days or until they can be transitioned to an in-network facility capable of meeting their clinical needs. If an in-network provider capable of meeting a member’s clinical needs is not available, BlueCare will work with those members so that they can continue to receive services at Methodist Le Bonheur facilities. BlueCare will also coordinate care for members who are in the middle of a specific course of treatment,” she wrote.
If members have specific questions about their care, Lawrence said they can reach out to BlueCare at: 1-800-468-9698. For additional questions about the negotiations, Blue Cross Blue Shield has created a website with more information.