Blue Cross Blue Shield (BCBS) of Oklahoma members may be out of network at Grady Memorial Hospital next month.
On Tuesday, Warren Kean Spellman, Grady Memorial Hospital CEO said the hospital is still awaiting a response from Blue Cross Blue Shield since their counter offer two months ago.
Spellman said rural hospitals are being treated unfairly by BCBS. The CEO said he has noticed a trend with rural hospitals being offered less compensation, especially those who have passed a sales tax.
Because this is not an isolated incident for rural hospitals, Spellman said the problem may need to be solved through legislation.
Other smaller hospitals, such as those in Purcell and Hobart, have been forced to take less from BCBS. These communities also have fewer options for healthcare compared with metropolitan areas.
Spellman said so far, proposed agreements from BCBS have been overly complicated and perpetuate the same situation.
The sales tax, which passed in Grady County in 2016 does not cover operational costs for the hospital, Spellman said.
The insurance company and the hospital have been undergoing negotiations since May 2019. The hospital's agreement with Blue Cross Blue Shield ended in July but an extension was granted until Oct. 28, 2019.
Blue Cross Blue Shield members may still go to Grady Memorial Hospital but out of network rates will apply. BCBS members may find their co-pay goes up. Spellman said the average has been about 20%.
Spellman said it is possible that BCBS may wait until or just before the Oct. 28 deadline. He said that even larger hospitals such as Integris in Oklahoma City have gone out of network for a period of time during such negotiations.