Attempting to quell concerns raised by reports that patients covered by Medicaid would not be covered at Bayonne Medical Center, hospital representatives said the hospital is currently negotiating with Horizon Blue Cross Blue Shield, which manages New Jersey’s Medicaid program for that hospital.
BMC and Horizon recently came to an agreement that would have allowed BMC to become an in-network provider for patients covered by Horizon. But some reports suggested the patients covered by Medicaid would not be served.
“Recent news reports that BMC will not serve Medicaid patients are just plain inaccurate and misleading.” – Dan Kane
____________
While all hospitals must treat patients who arrive in the event of an emergency situation, such as the result of a car accident or fear of heart attack, hospitals may opt out of contracts with some providers who they feel do not pay a rate that adequately covers hospital costs for in-patient services. Reimbursement rates under Medicaid are among the lowest from all providers.
BMC, which recently reached an agreement with Horizon, had dropped contracts with Horizon and other insurance carriers because of the rate of reimbursement they gave in exchange for including BMC as an in-network provider. Contracts with hospitals usually assure insurance carriers a discounted rate on various procedures. In dropping the contracts, BMC claimed that insurance carriers were asking for discounts that did not allow the hospital to cover its own costs, and, in some cases, did not even honor legitimate claims submitted by the hospital.
In September, BMC came to an agreement with Horizon for a new contract that would provide the hospital with better reimbursement. But some reported that Medicaid would not be honored at the hospital, something that Kane said was inaccurate.
“While BMC continues negotiations with N.J. Health, all Managed Medicaid members may seek care at BMC, as they always have been welcome to, irrespective of participation status with their Managed Medicaid plan,” Kane said. “Our efforts toward these agreements with both Horizon and N.J. Health further reinforce our commitment to our patients and highlight our mission to provide high quality care for the citizens of Bayonne and Hudson County communities.”
Some of the principal owners of BMC are also involved in the purchase of a hospital in Hoboken, and Kane said there are negotiations for coverage there, as well.
“Hoboken University Medical Center (HUMC) is also negotiating with N.J. Health, as well as the three other New Jersey Managed Medicaid plans and fully expects to be a participating in-network provider with them by the close of the sale of the hospital to HUMC Holdco,” Kane said.