Consumer Alert: Protest over health care fees

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“Ain’t gonna let no system walk all over me” echoed through Washington Square Park Wednesday, a block from the offices of Excellus BlueCross BlueShield.

“We think it’s outrageous how BlueCross treats its patients and how it treats providers,” said Ursula Rozum.

She’s with Citizen Action of New York, which was sending a message singing “Rich Man’s House,” a famed anthem of the Poor People’s Movement, claiming Excellus is the embodiment of health insurer greed: profiting from denying care.

“There’s countless patients that are getting their claims denied. Less than 1 percent of patients even fight back against these denials,” said Rozum.

This protest on the doorstep of Excellus occurs coincidentally at the same time the insurer battles WellNow Urgent Care over the reimbursement rates it pays the urgent care provider. The two are now in a standoff that could result in Excellus members losing access to care at WellNow unless they pay out of pocket.

In its statement, Dr. Robert Biernbaum, the chief medical officer of WellNow, places blame for the fight at the foot of Excellus, saying the insurer has refused to negotiate new reimbursement rates since 2016, even though it raised its premiums 45 percent.

He pointed out that public records show Excellus collected $6.6 billion in premiums last year and pay for its top four executives exceeded $6 million.

Dr. Biernbaum concluded his statement by writing, “Pretty good for a local nonprofit.”

A spokesperson for Excellus countered that argument, writing, “Last year, 91 cents of every dollar paid in premiums went to medical claims and activities that improve quality of care and their annual net income averages less than 2 percent of premiums collected.”

The insurer argued WellNow provides essentially primary care, but it’s demanding a reimbursement rate that far exceeds what local primary care providers get.

But these protesters say the problem is a bigger than the fight between this insurance and a provider.

“We need major healthcare reforms that adjust healthcare rates so that all providers can be paid fairly,” Rozum said.

Citizen Action of New York held protests at 15 Excellus offices across the state.

As for the fight between Excellus and WellNow, the latter says it’s unfair to say it’s unfair to reimburse them at the rate of primary care doctors because it provides much more, bridging the gap between primary care and the emergency room.

If the two sides can’t agree on rates in 30 days, WellNow will leave the Excellus network effective Dec. 31.