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Methodist Le Bonheur and BlueCross BlueShield of Tennessee reach agreement. Here's who it will, and won't, impact

The companies said the agreement affects members covered by BlueCare Tennessee, TennCare Select, CoverKids and BlueCare Plus, the Dual Special Needs Plan (D-SNP).

MEMPHIS, Tennessee — BlueCross BlueShield of Tennessee (BCBST) and Methodist Le Bonheur Healthcare said Wednesday they have reached an agreement for BlueCare Tennessee plans with cover Tennessee Medicaid members.

According to a news release, the new agreement is effective immediately, and “supports in-network access to Methodist and Le Bonheur Children's Hospital facilities for members covered by BlueCare Tennessee, TennCare Select, CoverKids and BlueCare Plus, the Dual Special Needs Plan (D-SNP).”

The insurance company and hospital leaders said they are continuing negotiations on an agreement to restore access for members covered through employers or with individually purchased plans.

In a separate news release, Methodist leaders said, "Methodist Le Bonheur Healthcare leaders continue to strive for a reasonable agreement with BCBST, while it continues its gamesmanship, catching patients in the middle. Its claims of relying on other facilities for care are not working. This is one of the reasons we pushed for this agreement with TennCare and BlueCare, to help alleviate the burden on those we serve.

The fact is, BCBST does not have a sufficient network capable of handling the volume of patients that MLH hospitals treat in our community.

While we are delighted to get this accomplished on behalf of TennCare patients, we will continue to fight for the interest of the thousands of BCBST patients in our community who remain out of network."

BlueCross said Medicare Advantage members are not impacted by the dispute.

“Providing the safest and highest quality care to our community, especially our most vulnerable patients, remains our top priority,” said Michael Ugwueke, president and CEO of MLH. “This agreement, while a major step forward, represents a fraction of what we can accomplish when insurance companies put the interests of their patients first. We look forward to continued negotiations to return insurance coverage to all of the BCBST members we are so privileged to serve.”

“We’re pleased to continue our vital and beneficial work alongside Methodist Le Bonheur Healthcare for the people of West Tennessee,” said Amber Cambron, president and CEO of BlueCare Tennessee. “This contract ensures that BlueCare members will be able to access health care, long-term support services, childhood wellness visits and more with support from the teams they trust.”

BlueCare covers more than 630,000 members across Tennessee, including roughly 200,000 members in West Tennessee.

For more information about BlueCare Tennessee, visit bcbstnews.com.

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