Suits against Blue Cross offers glimpse into reform problems

A small Michigan battle with the state’s dominant insurer and a major hospital is being watched by insurance companies, federal regulators and consumer advocates, who say it provides a glimpse into why it is so difficult to rein in insurance and health care costs.

What it means for health care reform is a matter of debate among the three groups. But one thing is fairly certain: neither this nor other court cases will stop insurance premiums from continuing to rise.

According to a USA TODAY report earlier this month, TheraMatrix has been providing Ford Motor Co. a low rate for physical therapy services for the automaker’s employees, retirees and their families, resulting in millions of dollars in savings annually. TheraMatrix then sought to sign up Chrysler and General Motors, as well.

That’s when Blue Cross Blue Shield of Michigan and the state hospitals allegedly tried to destroy the company, according to court records. The records show Blue Cross barred TheraMatrix from its medical provider network, which covers 70 percent of the state’s patients, for more than a year. In addition, the state hospital association told members they had an option to revoke Blue Cross discounts to any employers who “carved out” categories of care, such as physical therapy, USA TODAY reported.

Leave a comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.