North Carolina Blues Throw Down the Gauntlet with Feds

North Carolina Blues Throw Down the Gauntlet with Feds

Blue Cross and Blue Shield of North Carolinas (BCBSNC) says the federal government is trying to run out on a bill that amounts to $147.5 million in overdue risk-corridor payments. The Justice Department counters that the suit—along with several others that revolve around the 3-year-old program—is premature because any payments wouldn’t be due until next year at the earliest. BCBSNC is eager to have its day in court though, and says the government’s defense is …

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Advantage, Urgent Care? Plans Are Already Passing ACA Losses Off on Members

Advantage, Urgent Care? Plans Are Already Passing ACA Losses Off on Members

Urgent care operators may have new leverage when negotiating reimbursements or appealing to cash-paying patients in North Carolina. Blue Cross and Blue Shield of North Carolina (BCBSNC) says it has lost $280 million by covering residents under the Affordable Care Act (ACA, or “Obamacare”)—and in response, it’s filing for a 2017 rate increase of 18.8%. BCBSNC says higher-than-expected ED visits and orthopedic treatments (the cost of which could be greatly diminished if appropriate patients visited …

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