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HEALTH Grants Hold On BCBSRI Material Modification Application

PROVIDENCE – The Rhode Island Department of Health (HEALTH) has announced that it has granted Blue Cross and Blue Shield of Rhode Island's (BCBSRI) request that HEALTH suspend its review of BCBSRI's material modification application for the potential termination of Landmark Hospital from its coverage network.

HEALTH granted this request after BCBSRI agreed to notify physicians who have admitting privileges only at Landmark that it would not take adverse action against them based on a lack of participating hospital privileges. The company had notified physicians in July that it would require them to seek admitting privileges at another participating hospital.

"HEALTH recognized the difficult position that Landmark physicians faced in this situation," said Michael Fine, MD, director of HEALTH. "We requested that Blue Cross notify physicians that they are not required to have admitting privileges at a Blue Cross-participating hospital to remain as a participating Blue Cross provider. While we are now satisfied that this situation will not affect the relationship that patients have with their doctors in Woonsocket, we call on Blue Cross to move forward quickly in communicating this information to all Rhode Islanders."

HEALTH's review of BCBSRI's material modification application has been suspended for 60 days, effective September 17, 2012.


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