Nason Medical Center will remain in-network for BlueCross BlueShield of South Carolina, despite an announcement in June that the health insurance company planned to cut the urgent care provider from most plans in October, the insurer said Friday.
"Nason's leadership demonstrated a good faith effort in working with us to address cost concerns," said Jim Deyling, president of the BlueCross BlueShield private business division.
The company has not reached an agreement with Medcare Urgent Care but conversations with owners are ongoing, BlueCross BlueShield spokeswoman Patti Embry-Tautenhan said. The insurance company plans to drop Medcare from its network after Oct. 8.
"Quite frankly at this point, we feel like we're being bullied and singled out because we're a minority-run company," said Dr. Radwan Hallaba, who owns Medcare Urgent Care. Hallaba was raised in South Carolina, but his relatives are North African. His business partner is Mexican-American.
BlueCross BlueShield has drawn significant criticism for its decision to narrow its urgent care network since the news broke in June.
"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."
Medcare is a statewide practice. Nason Medical Center operates five urgent care facilities in the Lowcountry.
Embry-Tautenhan previously explained that the company needed to cut some urgent care providers from its network 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 never cited the investigation as a factor in the insurance company's decision to drop Nason Medical Center from its network. It was not mentioned in a press release issued Friday afternoon about the agreement.
"We have found BlueCross to be honest and fair in our discussions," Dr. Barron Nason said in a prepared statement. "Now we can get back to focusing on urgent care that is fast, friendly and affordable."
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.
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."
Reach Lauren Sausser at 937-5598.
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