Some cancer patients at N.J. center may have to move

[flashl]

July 27, 2008
BY CAROL ANN CAMPBELL

Star-Ledger Staff

A bureaucratic tangle in the complex world of health insurance means 1,000 cancer patients at Memorial Sloan Kettering's new center in Basking Ridge may be forced to find new doctors.

The cancer center recently sent letters to patients covered by Horizon Blue Cross Blue Shield of New Jersey, telling them they will be charged out-of-network prices after Sept. 1 at the Basking Ridge center. The patients can avoid the higher charges by switching their care to Sloan Kettering's Manhattan hospital, the letter said.

The change creates the odd situation of patients with New Jersey health insurance leaving a New Jersey cancer center to obtain in-network prices in New York.

...

The facility opened in 2006 and has treated about 5,600 patients in the past 12 months.

Insurance companies negotiate prices with hospitals to get the best deals for their members. Patients with certain policies who use those in-network facilities will pay less out-of-pocket, often much less.

[dflprincess]

1. This is happening in Minnesota as well

Blue Cross/Blue Shield of MN appears to be parting company with Fairview Hospitals & Clinics effective August 23 for outpatient and sometime in October for inpatient. The Fairview system is very large and includes the University of Minnesota hospital. (There is some hope that one side will blink before any of this comes to pass.)

And to think one of the arguments used against any kind of national program is that you won't be able to pick your own doctor. Sometimes it seems that the insurance companies are just begging for a single payer system.