Teamsters ‘outraged’ about BlueCross BlueShield urgent care decision

Aug. 01--BlueCross BlueShield of South Carolina continues to draw criticism for a recent decision to drop two large urgent care providers from its network later this year.

"The Local Union is constantly receiving calls from members on this chaotic BCBS decision and the members are outraged," wrote James Todd, a business agent for the Teamsters Local Union in West Columbia. "Particularly, our UPS members are mad as hell."

In a letter dated July 24, Todd urged the Central States, Southeast & Southwest Areas Pension Fund to use its leverage to "correct this crazy unprecedented decision of BCBS."

In June, BlueCross BlueShield, the largest private health insurance company in the state, confirmed it will drop Medcare Urgent Care and Nason Medical Center from its network in October.

Medcare is a statewide practice. Nason Medical Center operates five urgent care facilities in the Lowcountry.

Patti Embry-Tautenhan, a spokeswoman for the insurance company, previously explained that this decision was made to avoid duplicative services. She said the insurance company has explained to Medcare Urgent Care that its costs are outside the norm of other urgent care providers.

Nason Medical Center is currently under federal investigation. Details surrounding the ongoing case have not been made public, although Nason Medical Center owners confirmed in May that the government ordered the company to discontinue CT scans and ultrasounds.

Embry-Tautenhan did not cite the investigation as a factor the insurance company's decision to drop Nason Medical Center from its network.

The Affordable Care Act has forced insurance companies across the country to narrow their lists of preferred providers. The federal law no longer allows insurers to deny customers based on pre-existing conditions, so limiting network choices to doctors and hospitals that offer the highest quality care for the best price has become a more common way to control costs. Some experts also believe patients aren't entitled to cherry-pick their doctor when they're not responsible for the bulk of their bill.

Most BlueCross BlueShield customers will be affected by the change. They can continue to see providers at both Nason and Medcare but will be expected to pay out-of-network costs for their visits after Oct. 8.

Dr. Tim Pearce, president of the South Carolina Medical Association, appealed directly to the insurance company in a letter dated July 28, explaining that the group believes the decision to drop Medcare Urgent Care from the BlueCross BlueShield network "will have a negative effect on patient safety and satisfaction as well as cause disruption within the urgent care marketplace."

Charleston Mayor Joe Riley sent a similar letter in July. Dr. Radwan Hallaba, owner of Medcare Urgent Care, launched an online petition July 4, which, to date, has received more than 1,200 signatures.

Reach Lauren Sausser at 937-5598.

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