Houston-based Memorial Hermann patients in critical condition insured by BlueCross BlueShield of Texas are still covered under state law, despite the termination of its contract with the payer, Houston Public Media reported March 4.
Members of BlueCross BlueShield of Texas that are being treated for pregnancy, disability, acute condition or a life-threatening illness may be able to stay in network for longer, but must receive approval from the insurer.
"We do have a process for patients that are in the middle of a course of treatment, like cancer care, or have a long-planned staged surgery," Memorial Hermann Executive Vice President James McCarthy told Houston Public Media. "They can continue to have their care at the hospital they expected to, with the doctor they expected to, and not be subjected to any additional cost."
Memorial Hermann terminated the contract because of disagreements over reimbursement rates, and the system alleged the payer coerced physicians into unfavorable accountable care organization agreements.
Nearly 200,000 Memorial Hermann patients will be out of network because of the split, according to Houston Public Media. BlueCross BlueShield of Texas contracted with some physicians who were previously affiliated with Memorial Hermann, according to BlueCross BlueShield of Texas' website.