Policy: Health Care

State insurance payments delayed by Blue Cross

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News,Business,Health Care

BATON ROUGE, La. (AP) — Doctors, hospitals and other providers aren't getting paid for the care they deliver to a quarter-million state employees and retirees insured through the Office of Group Benefits.

Blue Cross and Blue Shield of Louisiana recently took over the management of the agency that had overseen health care coverage for state employees and retirees.

The Advocate reports (http://bit.ly/1hdkEnL ) Blue Cross notified the state by letters that payments would be delayed while computer programs were upgraded.

Blue Cross says patients should not be affected, but physicians and health care providers may not get paid for six to eight weeks.

Brian Keller, a senior vice president of Blue Cross and Blue Shield of Louisiana, said the computer alterations deal with health plans benefit changes made by the state agency and were finalized Dec. 11.

Blue Cross asked the Jindal administration for a waiver of penalties that would normally be due for untimely payment of claims.

The Jindal administration privatized the work, citing a cost savings. Blue Cross stands to make $37.8 million annually to serve as administrator.

"We are working closely with (Blue Cross/Blue Shield), and if this impacts Blue Cross' ability to meet its performance standards for claims processing time as required in their contract, we will apply the appropriate penalty," wrote Doug Baker, a Jindal administration spokesman, in an email response.

Baker said 2013 claims are being paid, just not new ones filed for 2014. There will be no disruption in services to members, he wrote.

Late Monday, Baker said all of the problems and changes were caused by the Affordable Care Act. He said the state made no other alterations in the plans that had any effect on the situation.

Blue Cross and Blue Shield of Louisiana's communications chief, John Maginnis, also blamed the Affordable Care Act mandates, though that was not mentioned in Blue Cross' initial letter seeking a waiver of contract requirements.

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Information from: The Advocate, http://theadvocate.com

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