An urgent care operator has accused Blue Cross Blue Shield of South Carolina of trying to restrict competition among urgent care centers by refusing to allow any new ones into its network in the Palmetto State—possibly due to a conflict of interest, they say. BCBS has called the anticompetition charge “an unfounded attack on the company’s integrity.” Nevertheless, state legislators Mike Burns and Bill Chumley see the urgent care operator’s point and have asked for a meeting with BCBS of South Carolina in the hope of persuading the insurer to open its books so patients have more options, and are not forced to pay out-of-network fees when they walk into an out-of-network facility. The issue came to a head when five American Family Care (AFC) locations in South Carolina were denied entry into the BCBS preferred provider network on the grounds that BCBS was “holding off accepting any new centers,” as AFC Medical Director Jeff Harris, MD has been quoted as saying in local media outlets. Since the initial rejection, BCBS has cherrypicked some AFC locations to accept into its network, though none are in the preferred plan (which insures the most BCBS members). Further raising the ire of AFS and the state reps taking up their cause: The locations that were barred from the network are within 3 miles of a Doctors Care location—which is affiliated with a hospital owned by BCBS.
Lawmakers Want to Meet with BCBS Over Claims That It Stifles Urgent Care Competition