Georgia's governor is hoping to put to rest to a standoff between a hospital and an insurance company, where over half a million beneficiaries are trapped in limbo, threatening to take matters into his own hands.
Piedmont Healthcare and Anthem Blue Cross of Georgia have failed to meet an April 1 deadline on new terms after months of discussions about new payment terms at the Atlanta-based health system. As a result, 650,000 beneficiaries, including state employees and retirees, are now out of network, causing financial problems for both providers and patients.
"We understand the disappointment of our consumers, as many of our own employees who receive care through Piedmont are also affected, and we are very disappointed by the disruption caused by Piedmont’s rejection of our offer," the insurer said in a statement.
Gov. Nathan Deal gave the companies a deadline of close of business Tuesday to come to an agreement or he threatened to "initiate executive action."
I asked @AnthemInc and @PiedmontHealth to resolve their contract dispute by COB tomorrow or the state will be forced to initiate executive action.
— Governor Nathan Deal (@GovernorDeal) April 16, 2018
Piedmont has fired back and claimed that Anthem's coverage is too low for the services provided.
"What Anthem Blue Cross is offering our doctors does not even cover the annual rate of inflation, but they will tell you that we are asking for unfair rate increases," the hospital said in a statement. "People should be paid fairly for the good work they do. This is part of the fabric of our country and a core value we share with our communities."
The standoff has been boiling for months. In February, Piedmont sued Blue Cross Blue Shield of Georgia, accusing the company of a "national scheme" to stop paying when some patients receive MRIs and CAT scans in hospitals rather than at free-standing imaging centers.