MEMPHIS, Tenn. — If you have Blue Cross Blue Shield of Tennessee, you will no longer be covered at Methodist healthcare facilities. That also includes Le Bonheur Children’s Hospital.
Blue Cross released a statement saying in part:
“The rates Methodist Le Bonheur healthcare system charged us were significantly higher than our average rates for other facilities in the Memphis area – and in the case of Methodist Le Bonheur Children’s Hospital, their rates were the highest of any children’s hospital in Tennessee by far.”
Blue Cross said negotiations to get their customers more affordable coverage broke down.
“For several months, we have tried to reach a new agreement but Methodist has not accepted a contract that brings them in line with other local providers. We value the care they provided but we have to meet our member’s need for affordable coverage,” said Dayla Qualls White with BlueCross BlueShield.
Methodist released a statement saying they were not able to reach a resolution, saying “because of Blue Cross’ refusal to negotiate in good faith, patients will be out-of-network as of today.”
Blue Cross BlueShield has listed the following impacted locations:
- Methodist University Hospital
- Methodist Healthcare – Germantown
- Methodist Healthcare – North Hospital
- Methodist Healthcare – Olive Branch Hospital
- Methodist Healthcare – South Hospital
- Methodist Blood and Marrow Transplant Center
- Methodist Comprehensive Breast Center – Germantown and Midtown locations
- Methodist Le Bonheur Children’s Hospital
- Methodist Le Bonheur Germantown
- Methodist Le Bonheur Germantown Surgery Center
- Wolf River Surgery Center (effective Oct. 23, 2023)
The following facilities have been removed from Blue Network SSM:
- Methodist Le Bonheur Children’s Hospital
- Methodist Le Bonheur Germantown
In addition, the following facilities have been removed from Network S permanently as of Jan. 1, 2023:
- Methodist Alliance Home Care Services
- Methodist Alliance Home Medical Equipment
- Methodist Healthcare Minor Medical Center (Cordova, Hacks Cross, Midtown Memphis, Olive Branch)
- Methodist Le Bonheur Germantown Surgery Center
- Wolf River Surgery Center (effective Oct. 23, 2023)
- Methodist Alliance Hospice (effective Oct. 31, 2023)
They are telling Blue Cross customers to re-schedule their visits and talk to their employers about switching their insurance to another provider.
Currently, there are 14,000 people who work for the city of Memphis that are covered under two city plans.
Several Blue Cross plans are affected including Blue Network, BlueCare Tennessee, TennCare Select, CoverKids, the Dual Special Needs plan, and Network S.
Insurance agent Chuck Hudspeth said he already has clients that are affected reaching out to him about changing their insurance policies.
“I have some customers that are paying higher premiums to go to both hospitals and that is no longer true now. So some of them are not going to be happy about this either and they will probably end up trying to make changes,” he said.
Hudspeth says it is hard to say when the back and forth will end.
“To me, it kind of reminds me of a game of chicken and we are waiting to see who blinks, but both are really big organizations and it could be that none of them blinks,” he said.
This insurance fight getting the attention of state lawmakers.
Congressman Steve Cohen sent Gov. Bill Lee an open letter urging him to get involved in the contract talks, writing in part, “Tennessee must not allow thousands of its most vulnerable children to be held hostage to a dispute between state contractors.”
In his letter, Cohen also called on the governor to direct TennCare to make special arrangements for children so they can continue receiving specialized care at Le Bonheur Children’s Hospital.