Blue Cross and Blue Shield of Texas and Farmers Branch-based Southwestern Health Resources will have no in-network contract with each other after Oct. 3 without a new agreement, WFAA reported Sept. 20.
The Dallas Morning News reported the impending break could leave up to 450,000 people without in-network coverage across the northern part of the state.
Southwestern Health Resources operates 29 hospitals, including Presbyterian in Dallas, Arlington Memorial and Harris Methodist in Fort Worth. In total, the system serves more than 7 million people through Texas Health Resources and University of Texas Southwestern Medical Center in Dallas. Combined they have more than 5,500 physicians and other clinicians.
BCBS, the state's largest payer with 5 million members, said it received a notice from Southwestern that it would go out of network if an agreement over reimbursement rates could not be reached. The two have been negotiating since July 2021.
"SWHR's rate demand is clearly not in the best interest of our members, Dallas Fort-Worth businesses or the communities we serve," a BCBS spokesperson told WFAA.
Members enrolled in BCBS' Par Plan, Blue Choice PPO, Blue Essentials, Medicaid and Medicare Advantage (both PPO and HMO) would all be out of network.
"We continue to negotiate and remain committed to reaching an agreement as soon as possible," the provider told WFAA.