Political Notes – Grady, Blue Cross don’t agree on contract, battle of the airwaves begins

Grady Health Systems and Blue Cross Blue Shield of Georgia were not able to resolve their contract negotiations this week, which means that one of the state’s largest hospitals (Grady Memorial) is officially “out of network” of the facilities covered by the state’s largest health insurer.

The two healthcare giants could not come to an agreement over how much Blue Cross would reimburse Grady for the services provided to patients who get their health insurance coverage through Blue Cross .

This means that Blue Cross patients receiving medical care at Grady could now be subject to higher “out of network” costs for any treatments they get – a difference in price that can be very substantial.

The two entities have already been fighting the battle of the press handout.

A Grady spokesperson said earlier this week that Blue Cross “pays our health system up to 70 percent less than it pays other Georgia hospitals. By paying us unfairly low rates, Blue Cross Blue Shield has long put Grady at a disadvantage and threatens our long-term sustainability.”

Blue Cross spokesman Tony Felts responded, “We pay fair reimbursement to Grady Health System for the care they deliver, consistent with our arrangements with other Level 1 Trauma hospitals in the state. Unfortunately, Grady is seeking a reimbursement increase that is significantly higher than the rate of inflation.”

The battle is now shifting to the airwaves, with Grady already starting to air TV commercials aimed at pressuring Blue Cross to agree to a contract and put Grady Memorial back into its network.

These commercials were aired during some of the football games broadcast on Thanksgiving Day. One commercial, shot in a stark, black-and-white setting, features a man and a woman, presumably a married couple, talking to the camera.

The man emotionally explains that he is 41 years old and recently had life-saving brain surgery at Grady, implying that the treatment wouldn’t be covered by Blue Cross.

Uber leaves Nevada, but what about Georgia?

The internet ride-sharing service Uber, which has dreams of ousting the established taxi service providers on its way to becoming a multi-billion-dollar company, will apparently have to accomplish that goal in states that don’t include Nevada.

Uber shut down operations in Nevada this week after Washoe County District Court Judge Scott Freeman issued a preliminary injunction preventing the San Francisco-based company from operating statewide. Freeman acted after a panel of the Nevada Supreme Court directed his court to hear the case.

The company began operations in Nevada in October, but ran into regulatory opposition from the Nevada Taxicab Authority and the Nevada Transportation Authority, which charged that Uber’s drivers were illegal unlicensed carriers.

The battle is now expected to shift to the Nevada legislature, where lawmakers will likely consider revisions to the state laws governing transportation carriers.

There could also be action on the legislative front in Georgia.

Rep. Alan Powell (R-Hartwell), who introduced legislation last session to regulate ride-sharing companies like Uber and Lyft, heads a study committee that was tasked to review for-hire transportation services and recommend what level of regulation might be needed, if any.

He has not yet announced any meetings for that study committee.

No hard feelings? Hardly

The elections are over for this year, but the hard feelings obviously haven’t faded away.

Reports the Marietta Daily Journal:

Is U.S. Rep.-elect Barry Loudermilk (R-Cartersville) carrying a grudge, or does he just have an overzealous press secretary?

On Thursday, the MDJ rang Dan McLagan, Loudermilk’s media spokesman, to request a phone interview with Loudermilk about Obama’s immigration proposal. The MDJ also wanted to write a profile on Loudermilk as an incoming congressman.

McLagan replied the MDJ “had done itself no favors” and was not at the top of Loudermilk’s list of calls to return due to coverage of his campaign.

MDJ news editor Jon Gillooly answered that while it was true the MDJ’s editorial section endorsed Loudermilk’s Republican primary challenger, Bob Barr of Cobb, the news section remained neutral during the race.

McLagan said maybe the relationship “could be repaired” sometime in the future, but meantime, don’t count on speaking to Loudermilk.

Gillooly tells Around Town he suspects McLagan’s high-handedness is not shared by Loudermilk, who he always found to be a friendly, easy-going state senator. Around Town shares that assessment.

© 2014 by The Georgia Report


Tags: Alan Powell , Barry Loudermilk , Blue Cross , Dan McLagan , Grady Health Systems , Marietta Daily Journal , out of network , reimbursement contract , ridesharing services , Uber