Rural hospitals sue Blue Cross Blue Shield of Oklahoma over drastic reimbursement cuts

Haskell County Community Hospital
(Photo provided to The Oklahoman)

Four rural Oklahoma hospitals have sued Blue Cross Blue Shield of Oklahoma for breach of contract over crippling proposed provider reimbursement rate cuts, Dale Denwalt reports for The Oklahoman.

"BCBS does not favor supporting rural, critical-access hospitals," the lawsuit states. "BCBS, through its actions and behavior, is attempting to drive critical access hospitals out of business in favor of driving business to large metropolitan hospitals and related services."

BCBS has not confirmed the rate cuts it's asking for, but Don Buchanan, CEO of Haskell County Community Hospital in Stigler, said BCBS wants to cut reimbursement by 30 percent for all services except those in the emergency room.

"Unfortunately, it's not a rate that would allow us to continue to serve Blue Cross patients. It borders on being below the cost of actually providing that care," Randy Simmons, CEO of Prague Community Hospital, told Denwalt.

"In Prague, BCBS is the third-largest payer behind federal health care programs. Simmons said losing patients who use the insurer would be devastating for the hospital, and in turn would critically limit health care in the community," Denwalt reports. The other two hospitals named in the suit are Drumright Regional Hospital and Fairfax Community Hospital.

The hospitals' contracts with BCBS were set to expire Oct. 31, but a Tulsa judge issued a temporary restraining order. A hearing on the lawsuit is set for Nov. 3.