NEW YORK: Health Republic saga continues...enrollees given lifeline but what about providers?
The good news (relatively speaking) is that the 200,000-odd New Yorkers currently enrolled in about-to-be-defunct Health Republic NY Co-Op policies have been given an extra 15 days to find a new insurance provider (11/30 instead of 11/15), and that those who don't do in time will be automatically enrolled in a temporary (1-month only) policy with someone else to at least ensure coverage to tide them over through January. The temporary policy may or may not include their preferred doctors/hospitals, but it's better than having no coverage at all during the December gap period, anyway.
The bad news is that the hospitals & doctors who have been treating these folks until now may find themselves getting stiffed by the Co-Op's middle man, MagnaCare:
One of the largest provider networks in the state will no longer process claims from Health Republic Insurance customers, a decision that could impede coverage for thousands of New Yorkers during the next three weeks and force physicians, rehab centers, hospitals and health systems to provide care for which they are unlikely to be fully reimbursed.
MagnaCare, which contracts with doctors and hospitals and then rents that network to insurers, advised providers that they had been informed by the state that Health Republic claims payment will cease immediately, according to the Healthcare Association of New York State, which represents hospitals.
...MagnaCare functions as a middle-man between the insurer and the doctors and hospitals. It is responsible for setting prices with providers and charges insurers, such as Health Republic and Oscar, to rent out its network. That saves the insurer from having to contract with the thousands of providers throughout the city.
MagnaCare's decision to no longer process claims does not absolve providers of their contractual responsibility to provide care for Health Republic customers.
That contract remains valid through the end of November, but some patients are reporting providers have already started turning them away.
(sigh) Single payer is looking better and better every day...