Blue Cross Blue Shield of Texas customers no longer have in-network access to physicians and facilities of Houston-based health system Memorial Hermann, The Examiner reported March 3.
The change took place March 1, the report said, when the two entities were unable to reach an agreement for new contracts. More than 265 of the health system's care delivery sites and about 3,000 affiliated physicians and specialists are no longer under network coverage.
Some Memorial Hermann physicians and healthcare professionals have chosen to contract separately to remain in the insurer's network, the report said.
"For members whose providers have not chosen to contract directly with BCBSTX, we are making every effort to make sure members are moved to in-network doctors, hospitals and surgery centers as seamlessly as possible," BCBSTX said in a statement. "We are also working with in-network hospitals to speed up granting privileges to doctors who only have privileges at Memorial Hermann so they can continue to care for our members."
BCBSTX members covered by commercial PPO, POS, EPO, Blue Essentials HMO and Medicare Advantage HMO and PPO health plans are all impacted, as are BCBS out-of-state plan members who access BCBSTX local networks.
"This change means you'll face higher out-of-pocket costs when you visit a Memorial Hermann facility," BCBSTX CMO Mark Chassay, MD, told The Examiner. "It also means you may get a bill for additional costs that aren't covered by your policy."
The removal from BCBSTX's network will affect facilities including the following 22 Memorial Hermann ASCs and surgical hospitals:
1. Memorial Hermann Bay Area Endoscopy (Houston)
2. Memorial Hermann Endoscopy & Surgery Center (Houston)
3. Memorial Hermann Endoscopy Center North Loop (Houston)
4. Memorial Hermann Memorial Village Surgery Center (Houston)
5. Memorial Hermann Surgery Center Greater Heights (Houston)
6. Memorial Hermann Surgery Center Katy (Texas)
7. Memorial Hermann Surgery Center Preston Rd. (Pasadena, Texas)
8. Memorial Hermann Surgery Center Sugar Land (Texas)
9. Memorial Hermann Surgery Center Southwest (Houston)
10. Memorial Hermann Surgery Center Texas Medical Center (Houston)
11. Memorial Hermann Surgery Center Woodlands
12. Memorial Hermann Surgery Center Woodlands
13. Memorial Hermann Surgery Center Richmond (Texas)
14. Memorial Hermann Surgery Center West Houston
15. Memorial Hermann Texas International Endoscopy Center
16. Memorial Hermann Center Kirby Glen (Houston)
17. Memorial Hermann Surgery Center (Houston)
18. Memorial Hermann Surgery Center Conroe (Texas)
19. Memorial Hermann Surgery Center Brazoria (Angleton, Texas)
20. Memorial Hermann Surgery Center (Houston)
21. Memorial Hermann Sugar Land (Texas) Surgical Hospital
22. Memorial Hermann Orthopedic & Spine Hospital (Bellaire, Texas)