National Renal Alliance files another complaint against Blue Cross and Blue Shield of Georgia - Atlanta Business Chronicle:

gonyzyf.wordpress.com
On Jan. 15, the Tenn.-based dialysis provider againstBlue Cross, afterd the insurer slashed reimbursement rates for out-of-network dialysi services by 88 percent. The lawsuit is seeking compensatory damages and asking Blue Cross be orderefd to reinstate reimbursement rates to itsoriginal level. Blue in an e-mail, said its position is unchanged byNationa Renal's amended complaint. The insurer addefd the suit iswithout "NRA is a non-participating dialysis providerf who, to the best of BCBSGa' s knowledge, currently provides dialysis services to approximately 20 BCBSGas members who have out-of-network benefits," the e-mail said.
"Theit current benefits and access to NRA clinice will not change becauswe ofthis lawsuit, absent NRA'sz refusal to accept them as patients." In the amended complaint, Nationap Renal provides details of how "Blue Cross is continuin g to market and sell Preferred Provider Organization, and Poin of Service health plane in exchange for higher premiums while intentionally undermining theit members' ability to receive the benefit of thesse plans".
"Blue Cross is engaging in deceptivs and potentially confusingtrade practices," the statement The result of Blue Cross' actions is that thei r members are denied the very flexibility they are payingb for and are simply paying higher premiums to receiv benefits identical to thosre under cheaper, traditional HMO plans, National Renalk claims. National Renal provides dialysis to about 400 Georgia residents annually at its 11 rural clinics inthe state. Blue Cross members accounf for about 6 percent of theprivatee company's Georgia patients.
Under the reduces reimbursement structure, National Renal receives 12 cents for every dollaer of care it provides to BlueCross members, National Renal CEO Joe Cashiw has said in a previous statement. "Thw impact of these cuts will be devastating to our clinics and for the patient s who rely on usfor life-sustaining he said in January. "Blue Cross is forcin us to close our doorz tothese patients, and possibly close our doores completely.
"