South Nassau Communities Hospital officials announced on June 29 that they had reached a contract agreement with the health insurance agency Empire Blue Cross Blue Shield, ending an impasse in negotiations that had threatened coverage at the hospital for Blue Cross plan holders, including a wide swath of public-sector employees at the state, town school and county levels.
The financial details of the agreement were not disclosed.
“It was a good deal, a fair deal,” said Joe Calderone, South Nassau’s senior vice president of communications. “It was a tough negotiation, but I think Blue Cross and South Nassau negotiated in good faith, and in the end we both reached an agreement that will benefit our patients.”
The deal comes as a 60-day “cooling-off” period — after the contract between the two entities expired on May 1 — was set to end on July 1, which would have caused Blue Cross plan holders to pay out-of-network costs at the hospital for all non-emergency procedures. Contracts between Blue Cross and South Nassau are renegotiated roughly every three years.
A spokesperson for Anthem, Blue Cross’s parent company, confirmed that a deal between the insurance agency and hospital had been reached.
Calderone thanked local elected leaders for aiding in the negotiations, including State Sen. Todd Kaminsky, a Democrat from Long Beach; Assemblywoman Michaelle Solages, a Democrat from Valley Stream; Nassau County Legislator Denise Ford, a Republican from Long Beach; Assemblywoman Melissa Miller, a Republican from Atlantic Beach; and Town of Hempstead Councilman Anthony D’Esposito, a Republican from Island Park. The lawmakers, as well as more than a hundred hospital staff, had rallied on June 21 outside the hospital to ask Blue Cross to relent in its negotiations with the not-for-profit medical center. “I think that made a difference,” Calderone said.
Hospital officials had contended that Blue Cross had been shortchanging South Nassau in negotiations for years, and that reimbursements from the insurance agency for medical procedures were on average 40 percent less than those paid to neighboring hospitals.
“We’re looking for a fair and reasonable rate structure for our reimbursements,” hospital board Vice Chairman Tony Cancellieri said at the rally. “[It’s] something that all other hospitals on Long Island except South Nassau enjoy.”
Geri Barish, a five-time breast cancer survivor and executive director of the Hewlett House, a community resource center for families and individuals dealing with the disease, said that Blue Cross’s strong-arm tactics in the negotiations amounted to “taking someone’s arm, cutting it off and saying, ‘OK, fend for yourself.’”
“We’re fighting for our lives,” Barish said.
South Nassau serves roughly 900,000 patients on the South Shore.
Jerry Laricchiuta, president of CSEA Local 830, which represents roughly 10,000 public workers, including those in Nassau County government, said that the breakdown in negotiations was “not a good situation,” especially for employees living in Long Beach, Island Park and Oceanside, who rely on South Nassau for medical care.
And Ford, a Long Beach resident and longtime union telephone worker, said that Blue Cross plans for Nassau County and City of Long Beach workers “don’t come cheap” for those governments, and that after the loss of the Long Beach Medical Center in Hurricane Sandy, workers in the area must rely on South Nassau to fill the void.
For now, however, health insurance coverage at the South Nassau for those workers, as well as all nearby Blue Cross plan holders, will be preserved. “We’re certainly pleased with the deal,” Calderone said, “and it definitely puts us on firm financial footing.”
“Our patients will continue to have access to medical care at south Nassau,” he added, “and that’s the most important thing.”