November 11, 2014

BCBSNE to Extend In-Network Benefits for Members at Five CHI Health Hospitals Kearney, Grand Island, Nebraska City, Schuyler and Plainview Facilities Impacted

Effective January 1, 2015, BCBSNE members will pay in-network out-of-pocket amounts at CHI Health hospitals in five Nebraska communities, despite CHI's termination from BCBSNE's statewide provider network.

Members will receive their in-network level of benefits at these five facilities:  Good Samaritan Hospital in Kearney, Saint Francis Medical Center in Grand Island, St. Mary's Community Hospital in Nebraska City, CHI Health Schuyler and CHI Health Plainview.

That means members will pay in-network deductible, copay and coinsurance amounts at those facilities, and BCBSNE will pay the same amount for covered medical services at those facilities as it did prior to the September 1 network termination.  "We hope this eases the transition for our members, and provides them with options for care within their communities," said BCBSNE senior vice president Lee Handke.

BCBSNE made the move to help Nebraska members who would have to pay higher out-of-network costs if they had used the five CHI facilities -- which are the only full-service hospitals in those towns.

CHI Health was removed from the BCBSNE network in September because its costs are 10% to 30% higher for physician and hospital services in Omaha.  CHI Health had included all its facilities across Nebraska under one contract, which locked out members outside of Omaha from getting care at in-network rates.   BCBSNE proposed multiple times signing a separate agreement with CHI hospitals outside of Omaha, but CHI refused.

"We were hopeful of reaching an agreement with Denver-based CHI long before now -- especially in our efforts to take members in these five communities out of the middle of an Omaha problem," Handke said. "We made the decision to fix the problem on behalf of our members in those communities."

Because the five facilities are still out of network, BCBSNE will send payment for medical services directly to the member, who will be responsible for paying the provider.  CHI Health can still bill members for the difference between what BCBSNE pays and what the provider charges -- although CHI officials have stated publicly they will not bill members for the difference.

Members in the communities impacted by this upcoming change are receiving a letter from us later this week.  If you have any questions, please contact a member of your Blue Cross and Blue Shield of Nebraska account team.

Sincerely,

Pat Bourne

Senior Vice President, Sales and Account Services