Tri-City and Blue Cross to jumpstart negotiations

By: LOUISE ESOLA - Staff Writer | Monday, January 23, 2006 8:55 PM PST ∞

OCEANSIDE ---- Tri-City Medical Center will bring a new offer to the table when it meets with Blue Cross of California this week to hammer out a new contract, a hospital offical said Monday.

Officials with both the hospital and the insurance company confirmed Monday that they will resume negotiations this week on a new contract, but declined to say when or where the talks would take place.

Tri-City spokeswoman Susan Paparella said hospital negotiators will have a new proposal for Blue Cross.

"We are not going in with the same proposal that was presented in past negotiations," she said.

Blue Cross of California spokeswoman Leslie Porras declined to say whether the health insurance giant would also bring a new offer to the talks. In response to the North County Times' latest request for an interview with Blue Cross Chief Executive Officer David Helwig, she said the company's top man will not talk to the media before or during negotiations.

Neither side would provide details on issues to be negotiated.

Tri-City and Blue Cross ended negotiations in mid-December after six months of talks failed, leading to the lapse of the insurance contract on Jan. 1, so this week's resumption of talks would be good news for thousands of Tri-City patients covered by Blue Cross.

The insurance impasse has forced thousands of Blue Cross patients in the tri-city area of Oceanside, Vista and Carlsbad to either pay for nonemergency care out of their own pockets or to turn to other area hospitals with a Blue Cross contract for treatment.

Blue Cross says it is still covering emergencies, patients in the middle of continuing care such as cancer treatments, pregnant women who were already using the hospital, and doctors who do not have operating privileges at other hospitals.

Meanwhile, Tri-City Chief Executive Officer Art Gonzalez said last week that he would ask Blue Cross to resume coverage of nonemergency care for its customers while negotiators work on a new contract.

In 2002, when Blue Cross and Tri-City couldn't agree on a contract after the previous deal had expired, Blue Cross patients were still allowed to receive treatments and services at Tri-City while negotiators worked on a new pact.

That same break was not given to Blue Cross customers this time around. (North County Times employees are among the more than 19,000 covered by Blue Cross.)

Porras declined to comment Monday on whether Blue Cross would be open to Tri-City's request to resume regular insurance coverage for all its customers using Tri-City.

"That would be something we would not be able to speak about," she said, reiterating that details on negotiations are private.

The primary issue in the 2002 negotiations, hospital officials said, was the difference between what Blue Cross was willing to pay and what Tri-City wanted to charge for services at the hospital.

Tri-City has declined to say how many Blue Cross patients rely on the medical center, although officials said in 2002 there were 19,000 Blue Cross patients in the tri-city area.

A spokesperson for California Department of Managed Healthcare, which oversees the state's various health insurance companies, including Blue Cross, said last week that the agency has calculated that there are 27,000 Blue Cross patients within 15 miles of the hospital.

Contact staff writer Louise Esola at (760) 901-4151 or lesola@nctimes.com. To comment, visit nctimes.com.

Day 24

Negotiations scheduled: dates and details not disclosed

19,000 uncovered*

No comment from Blue Cross of California CEO David Helwig.

*2002 estimate

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