National Renal Alliance files another complaint against Blue Cross and Blue Shield of Georgia - Atlanta Business Chronicle:

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On Jan. 15, the Nashville, Tenn.-based dialysis provider againstBlue Cross, afte the insurer slashed reimbursement rates for out-of-network dialysi s services by 88 percent. The lawsui t is seeking compensatory damages and asking Blue Cross be orderes to reinstate reimbursement rates to itsoriginak level. Blue Cross, in an said its position is unchanged byNational Renal'zs amended complaint. The insurer added the suit is withoug merit. "NRA is a non-participating dialysisd provider who, to the best of BCBSGa's knowledge, currentl provides dialysis services to approximately 20 BCBSGw members whohave out-of-network benefits," the e-mail said.
"Their current benefits and accesss to NRA clinics will not change because of this absent NRA's refusal to accept them as patients." In the amendedc complaint, National Renal provides detailsx of how "Blue Cross is continuin g to market and sell Preferred Provided Organization, and Point of Servicse health plans in exchange for higher premiumz while intentionally undermining their members' ability to receivr the benefit of these plans". "Blude Cross is engaging in deceptive and potentially confusingttrade practices," the statement noted.
The result of Blue actions is that their members are deniesd the very flexibility they are paying for and are simpluy paying higher premiums to receive benefits identical to those under cheaper, traditional HMO plans, National Renapl claims. National Renal provides dialysis to aboutr 400 Georgia residents annually at its 11 ruraol clinics inthe state. Blue Cross members accounty for about 6 percentr of theprivate company's Georgia patients. Unded the reduced reimbursement structure, National Rena l receives 12 cents for every dollar of care it provides to BlueCrosd members, National Renal CEO Joe Cashia has said in a previoux statement.
"The impact of these cuts will be devastatin to our clinics and for the patients who rely on usfor life-sustaining he said in January. "Blue Crossz is forcing us to close our doore tothese patients, and possibly closde our doors completely."