Network Update: Empire Contract Termination of Providers in Essex County, NJ
Empire BlueCross BlueShield has a license agreement with the Blue Cross and Blue Shield Association (BCBSA) and this license allows Empire the ability to utilize the blue brands outside of its exclusive service area to contract with health care providers in a “contiguous county” (one county adjoining the plan’s service area) in order to serve its members residing or working in its service area. Over the past several months, Empire and the BCBSA have been involved in discussions regarding Essex County, New Jersey and its designation as a contiguous county. Based on those discussions, the BCBSA has determined that Essex County, New Jersey is not considered a contiguous county to the Empire service area. As a result of this decision, the BCBSA has directed Empire to terminate its contracts with all providers in Essex County. To comply, Empire is required to terminate its contracts with providers in Essex County no later than June 30, 2012.
Please note that the provider contract terminations will only impact Empire HMO or HMO/POS members seeking services with providers in Essex County. All Empire members with PPO, EPO, or Indemnity coverage can continue to access the services of Essex County providers through the BlueCard® Program.
Be assured we have you covered.
We understand and truly regret the inconvenience this has caused. We know how important having broad access to quality care in your community is to you and your family because it’s important to us and ours.
Also be assured that Empire has a robust network of participating hospitals, physicians, radiology centers, ambulatory centers and other providers capable of providing healthcare services for our members at numerous convenient locations throughout the surrounding contiguous areas. As always, emergency care will continue to be covered at any appropriate facility or hospital in Essex County, in accordance with member benefit contracts and governing state and federal laws. It is also important to understand that there will be no immediate interruption of care that is already underway at a facility in Essex County.
Members of the media can contact Sally Kweskin, Public Relations Director, at (720) 373-4836 or via email at firstname.lastname@example.org