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Mar 25, 2013 1:11 PMPublication: The Southampton Press

Empire Warns It May Go Out Of Network With East End Hospitals April 1

Mar 25, 2013 1:58 PM

Empire BlueCross BlueShield, the once-biggest health insurer on the East End, but which eliminated most of its small group plans in the New York market last year, sent letters to plan members this month informing them that it may not participate with East End hospitals effective April 1, if an agreement on reimbursement rates is not reached by then.

The announcement is not new and likely does not impact many people, according to Kevin Luss, a health insurance broker and financial planner at The Luss Group in Southampton Village.

Few people—mostly those who work for a municipality, as well as some small businesses—still have Empire, he noted.

Empire’s letter notes that it will go out of network with the East End Health Alliance—Southampton Hospital, Eastern Long Island Hospital and Peconic Bay Medical Center—by April 1. A small list of services that will be covered on an in-network basis includes emergency care and continuation of care for pregnancy.

But services will be considered in-network at EEHA hospitals if a network hospital is not within a 30-mile radius of a member’s home.

“The hospital has been extremely accommodating to people that have Empire,” Mr. Luss wrote in an email. “I would tell the reader not to worry.”

Marsha Kenny, a Southampton Hospital spokeswoman, said Alliance negotiations with Empire are ongoing in good faith.

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This will impact many people who live on the East End contrary to what Mr. Luss says. The nearest hospital will be Brookhaven Memorial Hospital in Patchogue for those who have Empire. Those without insurance will still be treated at the East End Health Alliance hospitals. I will be paying for their health care through my tax dollar while also paying for health insurance and forced to go elsewhere for treatment. Seems like a ploy to squeeze more money from Empire for those of us who pay our way. ...more
By crusader (391), East Quogue on Mar 26, 13 12:21 PM
Happy to report that as of late yesterday, Friday, April 6, Empire Blue Cross/Blue Shield and Southampton Hospital and the other members of the East End Health Alliance ratified their service contract. The contract is effective today, Saturday April 6th and will span 2 years.
By KevinLuss (356), Detroit, Michigan on Apr 6, 13 6:23 AM