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Sep 16, 2008 12:11 PMPublication: The East Hampton Press

Hospitals' contracts with insurers may expire

Sep 16, 2008 12:11 PM

The two hospitals that serve the South Fork of Long Island are in contract negotiations with two insurance providers, and looming deadlines could mean some patients will find themselves looking for a new hospital as soon as Friday.

While emergency care is never refused regardless of insurance status, Peconic Bay Medical Center in Riverhead and Southampton Hospital may stop accepting HIP Health Plan for non-emergency care at midnight on Friday, September 19. GHI policyholders face the same situation on October 5.

GHI and HIP are both under parent company Emblem Health, and Peconic Bay and Southampton Hospital are both under the East End Health Alliance, along with Eastern Long Island Hospital in Greenport. The three hospitals officially formed an alliance in June to cut costs and increase clout in negotiations with insurance providers. In May, the hospitals settled on a new contract with Empire Blue Cross Blue Shield, and in June they came to an agreement with Oxford and United Healthcare. Those negotiations, after several contract extensions, ended without any disruption in patient service.

“While the hospitals are making every effort to ensure that ongoing negotiations are productive and result in a new, equitable and timely contract, we are currently not seeing the progress we had hoped,” East End Health Alliance spokesman Paul J. Connor said in a press release.

The negotiations come down to reimbursement rates, the amount insurers pay to hospitals for the care they provide to policyholders.

Mr. Connor said it is critical to quality patient care that the hospitals’ reimbursement rates keep pace with the costs of providing the care. “As with all hospitals, our costs, including pharmaceutical, utility and labor expenses, continue to increase significantly,” he explained.

In addition to being the health alliance spokesman, Mr. Connor is also the president and CEO of Eastern Long Island Hospital. That hospital faces a November 13 out-of-network deadline with both HIP and GHI.

Emblem Health spokeswoman Ilene Margolin said the insurers are puzzled that the health alliance sees the need to “negotiate through the press.”

“We’re looking forward to ongoing productive discussion and looking forward to keeping them in our network,” Ms. Margolin said.

The alliance stressed that in a medical emergency, HIP and GHI policyholders can still come to the emergency rooms at any of the three hospitals and be covered by their health plan. It is only non-emergency care that will be affected.

The health alliance is posting updates on the negotiations at its website, www.healli.org. Concerned community members may also call 726-8555, 548-6080 or 726-3228 for information and updates. Southampton Hospital President and CEO Robert Chaloner will also periodically update a recorded message at 631-726-FACT (3228) as new information comes available.

HIP policyholders may contact HIP at 1-800-HIP-TALK (1-800-447-8255) and GHI customers can call 1-800-552-0103.

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