Blue Cross and Texas Health don’t have a deal with Oct. 4 deadline approaching

The current agreement between the healthcare groups and the insurance provider expires Oct. 4.

DALLAS — Blue Cross and Blue Shield of Texas and Texas Health Resources, one of the largest hospital systems in North Texas, have not reached an agreement for in-network services ahead of the current deal expiring on Oct. 4.

Blue Cross officials in a statement Tuesday said they received notice from Southwestern Health Resources – which includes Texas Health, along with UT Southwestern Medical Center – that it would be leaving Blue Cross networks after unsuccessful negotiations between the two sides.

In a joint statement from Southwestern Health Resources, Texas Health and UT Southwestern, the providers said patients with Blue Cross will remain in-network through Oct. 3 but that the two sides are still negotiating.

“We continue to negotiate and remain committed to reaching an agreement as soon as possible,” the joint statement from the providers said.

If an agreement is not reached by Oct. 4, the agreement between Blue Cross and the providers would expire, though some patients would qualify for continuity of care benefits, the providers said.

Patients who are going through a course of treatment or who are in their second or third trimester are encouraged to apply for continuity of care, which would extend their in-network access, the providers said.

Southwestern Health Resources officials said they’ve been negotiating with Blue Cross since July 2021.

Without a new agreement, UT Southwestern and Texas Health doctors would leave several Blue Cross and Blue Shield networks, including the Par Plan, Blue Choice PPO, Blue Essentials, Medicaid, and Medicare Advantage (both PPO and HMO), Blue Cross officials said.

Blue Cross officials said Southwestern Health Resources is “demanding a significant increases” in rates over the next 32 months, though the Blue Cross release did not disclose the specific rate hike.

“SWHR’s rate demand is clearly not in the best interest of our members, Dallas Fort-Worth businesses or the communities we serve,” said Shara McClure, Blue Cross and Blue Shield’s senior vice president for Texas Health Care Delivery. “As a customer-owned health insurance industry leader in Texas for more than 90 years, it is important to stand up for affordable care, especially in a time when most businesses and our members are facing inflationary pressures and a potential recession.”

Texas Health Resources operates 29 hospitals across North Texas, including Presbyterian in Dallas, Arlington Memorial and Harris in Fort Worth.

The company serves more than seven million people throughout the region.

  

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