Hospitals, insurer clash on “site of service” rules.
By Christopher Snowbeck Star Tribune
If you need a colonoscopy, should you get the procedure done in the outpatient department of a hospital or at a free-standing surgery center?
The answer for a growing list of medical procedures including colon cancer screening is becoming a big source of controversy for the state’s hospitals, an industry that’s well represented on the Star Tribune’s annual survey of Minnesota’s largest nonprofit groups.
Blue Cross and Blue Shield of Minnesota, the state’s largest health insurer, last year adopted new rules that steer some patients away from outpatient departments at hospitals for colonoscopy and certain services that the carrier said can be performed at a lower cost in surgery centers. The Minnesota Hospital Association cried foul in response, saying the moves could violate state laws and threaten revenue that hospitals use to subsidize other services.