State, county and town elected officials as well as roughly 100 medical center staff rallied outside South Nassau Communities Hospital in Oceanside on June 21 and called on state lawmakers to pressure the health insurance carrier Empire Blue Cross Blue Shield to relent in a contractual dispute between the two entities.
The impasse threatens to make Blue Cross plan holders responsible for nearly all of the costs associated with non-emergency visits to South Nassau starting July 1 if an agreement is not reached.
“We’re looking for a fair and reasonable rate structure for our reimbursements. [It’s] something all other hospitals on Long Island except South Nassau enjoy,” hospital board Vice Chairman Tony Cancellieri said. “We want nothing more, nothing less … The bullying stops today.”
Hospital officials contend that Blue Cross has shortchanged South Nassau in negotiations for years, and that reimbursements from the insurance agency for medical procedures are on average 40 percent less than those paid to neighboring hospitals.
In an emailed statement, Sarah Yaeger, a spokeswoman for Anthem, Blue Cross’ parent company, said that there would be no immediate change in health care coverage at South Nassau for Blue Cross plan holders, and that talks were still ongoing.
“We are continuing to negotiate to reach an agreement that would enable South Nassau Communities Hospital to remain part of Empire’s care provider network and protect affordability for our consumers,” Yaeger said.
The rally came amid a 60-day “cooling off” period after the contract between SNCH and Empire Blue Cross Blue Shield — which is renegotiated every three years — expired on May 1. Loss of coverage at the hospital would impact a wide swath of public-sector employees, including those working in Nassau County, the Town of Hempstead and New York state, as well as public schools staffs.
Barbara Stern, a retired Rockville Centre schools administrator, a Blue Cross plan holder and a 50-year South Shore resident said that South Nassau is her hospital of choice for biannual checkups on a pacemaker and defibrillator she had implanted, and that the results would be “devastating” for her should the hospital and the insurer be unable to reach an agreement.
“If South Nassau is no longer in-network, what am I supposed to do?” Stern asked. “I would have to find a new cardiac team.”
Geri Barish, a five-time breast cancer survivor and executive director of the Hewlett House, a community resource center for families and individuals dealing with the disease, said that Blue Cross’s actions amounted to “taking someone’s arm, cutting it off and saying, ‘OK, fend for yourself.’”
“We’re fighting for our lives,” Barish added. “I think this is more than playing hardball.”
Jerry Laricchiuta, president of CSEA Local 830, which represents roughly 10,000 public workers, including those in Nassau County government, said the breakdown in negotiations was “not a good situation,” especially for employees living in Long Beach, Island Park and Oceanside, who rely on South Nassau for medical care.
“When our police medics pick them up in that area, what are they going to do if we can’t take you to South Nassau?” Larricchiuta wondered.
“There’s got to be some regulation put in place,” Laricchiuta added, “or else our health care situation is going to blow up.”
County Legislator Denise Ford said that Blue Cross plans for Nassau County and City of Long Beach workers “don’t come cheap” for those governments, and that after the loss of the Long Beach Medical Center in Hurricane Sandy, workers in the area must rely on South Nassau to fill the void.
“If our ambulances have to drive further,” Ford said, “that blood will be on Blue Cross Blue Shield’s hands.”
Blue Cross is required by law to cover emergency room visits.
At least some elected officials suggested the state reconsider its contract with Blue Cross. The company provides coverage for the majority of New York’s roughly 1.2 million active and retired state employees, according to a 2016 report published by State Comptroller Tom DiNapoli’s office.
County Legislator Howard Kopel said that companies such as Blue Cross, which are guaranteed profits by government, have a “responsibility” to their clients, and that “companies that don’t take care of their customers,” he said, “get to lose some of that government support.”
State Assemblywomen Michaelle Solages and Melissa Miller said they would both support efforts to pressure Blue Cross in its negotiations. State Sen. Todd Kaminsky said he would do everything in his power to support South Nassau in its negotiations.
“I want Empire to know, they’re not just sitting down, one on one, with an executive of South Nassau,” Kaminsky said. “They’re sitting down dealing with all of us, and all of our families and all of our community.”