UCI Irvine Drops BlueShield Insurance – Contract and Reimbursement Rates in Dispute

I am so used to seeing this question in Massachusetts with compensation and contracts, but we have it here not in California with UCI wanting payments closer to what other university medical centers in California receive. BD

UC Irvine Healthcare has dropped its contract with Blue Shield of California over reimbursement rates, effective Dec. 1.

UCI is sending 2,050 letters to notify current patients of UCI Medical Center and the University Physicians and Surgeons practice, UCI said in a statement.

UC Irvine has asked Blue Shield to reimburse us at a level that is comparable to other university medical centers and sufficient to cover the cost of providing care. They have declined to do so.

Arminé Fortunato, vice president of provider network management, had this response:

In these difficult financial times, we are committed to keeping our rates affordable for our members. Blue Shield seeks financial arrangements with providers that are sufficient to cover their cost of providing health care, provide them with a fair margin and enable us to offer competitively priced coverage to employers and members. We feel that UC Irvine’s request for over a 40% rate increase is unreasonable and unjustifiable.

UCI is sending 2,050 letters to notify current patients of UCI Medical Center and the University Physicians and Surgeons practice.

The UCI statement also says UCI is open to resuming negotiations and directs members with concerns about the contract termination to write, e-mail or call Blue Shield at 888-235-1767.

UCLA dropped its Blue Shield contract in June 2008, but then reinstated it three months later.