Gov. Deal issues ultimatum in BCBS-Piedmont contract dispute

ATLANTA — Georgia Gov. Nathan Deal issued an ultimatum to Blue Cross/Blue Shield and Piedmont Health Care Monday to work out their contract dispute or the state will step in.

Blue Cross/Blue Shield and Piedmont have been in contract negotiations for months, but on April 1, that contract lapsed, which affected close to 600,000 people, most of them state of Georgia employees. If their doctors worked for Piedmont, those doctors can now be considered out of network.

The CEOs of both companies met with Gov. Deal behind closed doors Monday morning as he tried to push contract negotiations forward. But after it was over, no agreement was reached, prompting this tweet from the Governor’s Office:

He did not elaborate on what "executive action" could mean, but Channel 2 Action News learned that could include things like Georgia shopping around for a different insurer, to reopening Open Enrollment for state employees, to exploring new ways to increase patient access to health care options.

Deal directed the state to pay for any out-of-network costs for state employees for 30 days, but he continues to push both sides to reach a resolution.

The dispute is over proposed doctor payment rates.

Piedmont Healthcare has filed a lawsuit against Blue Cross Blue Shield of Georgia and its parent company, Anthem, over its emergency room policy.  Anthem changed its ER policy in Georgia in 2017 to review diagnoses after members' emergency room visits. If the condition is determined not be an emergency, Anthem may not cover the ER visit.  If you have had an ER claim denied by Blue Cross Blue Shield of Georgia email us at: investigative.tips@wsbtv.com

Cox Media Group