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Aug 18, 2009 5:57 PMPublication: The East Hampton Press

Still no deal for Alliance and Empire

Aug 18, 2009 5:57 PM

Empire Blue Cross Blue Shield and the East End Health Alliance have now gone nearly three weeks without a contract, three weeks during which Empire insurance has not been accepted at Southampton Hospital, Peconic Bay Medical Center in Riverhead or Eastern Long Island Hospital in Greenport, except in the case of emergencies.

Empire subscribers have been considered out-of-network at the three East End hospitals since August 1, when the contracts expired between the Alliance hospitals and Empire, the largest insurer in the region. Having failed to strike a new deal since then, most Empire policyholders have not been able to schedule tests or procedures at the hospitals, unless they decide to pay out-of-network costs.

Patients undergoing continuous courses of treatment are exceptions to the out-of-network deadline and will still be able to receive insurance benefits at the hospitals as though they are in network.

On August 4, the Alliance released a statement that it and Empire would observe a “quiet period” as negotiations resumed and would not release any more advertisements or comments to the press disparaging each other. East End Health Alliance spokesman Paul Connor III said Tuesday that both sides agreed to extend the quiet period, which was due to end last week, to this Friday.

“We still have another couple days and we’ll see where that takes us,” he said.

The quiet period is aimed at focusing efforts and energies on coming to an agreement.

The negotiations hinge on how much money Empire pays the hospitals to treat Empire subscribers. Alliance officials say the hospitals are paid so little that they lose money when they see patients with Empire insurance. Empire spokespeople say the hospitals are asking for a rate increase that would mean higher premiums for their clients.

“We are meeting and discussing on a very regular basis with hopes of resolving it,” Mr. Connor said.

Brendan O’Reilly

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