Florida Blue has notified about 31,000 clients they may lose in-network access to Memorial Healthcare System hospitals and doctors on Sept. 1 if the insurer and Broward County network fail to reach a new contract.
As of Wednesday, Memorial is no longer scheduling appointments beyond Aug. 31 for Florida Blue customers unless an agreement is reached. Appointments before then are not affected.
"Discussions are ongoing and productive, and we're hopeful of reaching a resolution," Florida Blue said in an online statement. "We're providing advance notice of the possibility that an agreement may not be reached."
On its website, Memorial stressed its commitment to remaining in-network but said it desired "fair reimbursement" from Florida Blue. The Jacksonville-based insurer said it's offering "market-based increases" consistent with other regional hospitals.
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According to Memorial, the negotiations affect Florida Blue's plans through employers and the Affordable Care Act marketplace, as well as Medicare Advantage. Also affected are customers with Anthem, Florida Blue Cross Blue Shield, Elevance and other Blue Cross Blue Shield plans from other states.
Should patients fall out of network, they would pay higher rates for some services through Memorial's hospitals, urgent care centers, specialty facilities and affiliated physicians.
If there is no deal by Sept. 1, emergency care will remain covered at Memorial under federal law. Also, Florida Blue customers in active treatment or who are pregnant may qualify for temporary in-network continuity of care.
This marks the second major contract standoff this summer between Florida Blue and a South Florida public hospital system. An impasse remains with Broward Health, whose contract expired July 1, leaving about 17,000 Florida Blue members out of network.
The Memorial system includes six hospitals, a nursing home and multiple affiliated providers. The South Broward Hospital District Board, which governs the system, recently approved construction of a $670 million expansion to its flagship, Memorial Regional Hospital in Hollywood.
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