Lawmakers seek answers on BCBSIL, Springfield Clinic dispute

Lawmakers sought answers Wednesday night on a contract dispute between Blue Cross Blue Shield of Illinois and Springfield Clinic that led the insurer to terminate its contract with the health system last year.

Rep. Sue Scherer, D-Decatur, said the House’s State Government Administration Committee hearing was not meant for lawmakers to poke their “noses” into the business of the two private entities, but rather to highlight challenges faced by constituents as a way to encourage further negotiations.

She has received calls in recent weeks from residents across central Illinois, from Springfield to Effingham, who say the dispute has disrupted their access to care.

“We’re not here to negotiate between Springfield Clinic and Blue Cross Blue Shield,” she said. “We’re here for our constituents.”

Krishna Ramachandran, division senior vice president of health care delivery at Blue Cross Blue Shield of Illinois, told lawmakers they have been working for nearly a year to find an agreement with Springfield Clinic. Despite a relationship dating back over 30 years between the two organizations, he said they have not been able to find a compromise with Springfield Clinic and its ask for higher rates.

“We’ve come to the table time and time again,” Ramachandran said. “But it takes two, and for the past year it’s been us sitting at the table across from an empty chair.”

Blue Cross has said about 55,000 customers were affected by the removal of Springfield Clinic from their network.

Both Springfield Clinic officials present at the hearing told lawmakers they were not involved with negotiations and could not speak on it.

Dr. Cheryl Brown, an obstetrician/gynecologist at Springfield Clinic, said she has been unable to see her Blue Cross patients and is concerned about whether they’ve been able to access proper care.

Additionally, she was dismayed to look online at Blue Cross’ in-network physicians and see nonexistent offices and a mentor who retired over a decade ago.

“The patients of central Illinois deserve better,” Brown said. “The women of central Illinois deserve better.”

Scherer has filed a plan that, in part, would give the Illinois Department of Insurance authority to pursue emergency rules to update time and distance network adequacy standards and remove a confidentiality requirement for market conduct exams to allow the department to say that an insurance company is undergoing an exam.

DOI Director Dana Popish Severinghaus told lawmakers Wednesday the agency helped write the legislation, which would enhance consumer protections and create transparency.

“We look forward to engaging with the General Assembly and all stakeholders in these proposals and through the legislative-making process,” she said.

DOI announced last week it fined Blue Cross Blue Shield of Illinois’ parent company, Health Care Service Corporation, $339,000 for failing to submit requested information following the termination of its contract with Springfield Clinic.

The company said this week it has paid the fine. Popish Severinghaus said the department is still reviewing the submitted information to determine network adequacy.