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Tuesday, Sep 16, 2014
Health & Fitness

Insurance dispute may cost Nebraska patients

Published:

OMAHA, Neb. (AP) Thousands of people who visit doctors or hospitals in Nebraska associated with the Catholic Health Initiatives network may soon have to pay more if they have insurance from Blue Cross Blue Shield of Nebraska.

The contract between the big insurer and the medical network may expire Sunday because the two sides have been unable to agree on rates since Blue Cross voided the deal in June.

If an agreement can't be reached, all the Omaha-area doctors associated with Catholic Health Initiatives and CHI Health's hospitals statewide will no longer be in Blue Cross' network.

If that happens, going to an affected CHI Health facility or doctor will become significantly more expensive for Blue Cross policyholders.

Blue Cross says CHI Health, which used to be called Alegent Creighton Health, routinely charges 10 to 30 percent more than other Omaha hospitals. CHI Health says those figures are misleading and it believes its total cost of treatment is lower even if certain services cost more.

Both sides complain the other refuses to give up much in negotiations. Blue Cross and CHI Health have each set up websites offering their view on the negotiations, and Blue Cross has held several town halls for its policyholders.

CHI Health CEO Dr. Cliff Robertson said he believes Blue Cross never wanted to reach a deal before the contract expired.

"This is going to be a very turbulent, chaotic time for patients that Blue Cross created," Robertson said.

Blue Cross Senior Vice President Lee Handke said the problem is that CHI Health has refused to bring its rates in line with other Omaha-area providers. Handke said Blue Cross wants to keep CHI Health doctors in its network, but only at a fair price.

"We don't want them out of our network, but they're pricing themselves out of our network," Handke said.

Blue Cross said about 110,000 of its policyholders were treated at a CHI Health facility or by a doctor affiliated with that network in the past 18 months.

The contract covers all CHI Health hospitals in Omaha, Schuyler and Plainview. It also includes hospitals in Lincoln, Grand Island, Kearney and Nebraska City that are affiliated with Catholic Health Initiatives.

CHI Health's Mercy Hospital in Council Bluffs, Iowa, should not be directly affected by the dispute, but Iowa residents with Blue Cross policies who seek treatment in Nebraska would be.

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Online:

Blue Cross Blue Shield update: http://update.nebraskablue.com

CHI Health site on negotiations: http://bit.ly/1lcUl7r

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