By: Mark Maxwell, Renee Cooper
SPRINGFIELD, Ill. (NEXSTAR) — Political pressure is mounting for the Pritzker administration to take swift action to regulate Blue Cross Blue Shield of Illinois after a Target 3 investigation revealed a string of consumer protection concerns stemming from a contract dispute the state’s largest insurer has with Springfield Clinic.
Blue Cross Blue Shield of Illinois has justified its hardball negotiation tactics as an effective strategy to drive reimbursement rates lower at Springfield Clinic, but patients with severe and urgent medical issues are becoming the casualties of the insurance company’s leverage war.
When Blue Cross Blue Shield of Illinois (BCBSIL) kicked hundreds of Springfield Clinic doctors and nurse practitioners out of its network, it effectively blocked 55,000 of its paying customers from visiting their preferred specialists in critical fields, such as obstetricians and radiation oncologists. Springfield Clinic employs most of the area’s specialists in those fields, and often accepts referrals from other primary care doctors at other hospital groups in the capital city.