BCBS plans at center of prescription controversy - MSNewsNow.com - Jackson, MS

BCBS plans at center of prescription controversy

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JACKSON, MS (Mississippi News Now) -

You could be paying more for prescription drugs. Some doctors say it will depend on if you're in or out of network.

Blue Cross Blue Shield is the target of this fight. The insurer wants to charge more for those out of network prescriptions. This issue has made it all the way to the legislature.

"Anytime an insurance company gets between a doctor and his or her patients, that's not a good thing," said addiction medicine Dr. Randy Easterling.

This Blue Cross benefit plan summary says if an out-of-network doctor writes you a prescription, it won't cover the costs. Easterling says it doesn't surprise him.

"It disappoints me. Blue Cross Blue Shield has a market share in this state," explained Easterling. "Around 80 percent. So when they take a step, it effects everybody. and this pint, they're stepping on a lot of patients."

In a statement, the insurer says the provision only applies to certain benefit plans offered beginning January 2014. But we've learned that folks insured by the company for more than twenty years received the summary in January. Now the state medical association is raising a red flag.

"We would like to partner with the insurance companies not have to fight them on these type of issues because the patient ultimately is the person that it matters most to," said Mississippi State Medical Association President James Rish."And that's who's getting caught in the cross hair."

One of the greatest concerns is with psychiatric patients. Those doctors are typically out of network. Patients' medications can cost upwards of $700 a month.

"If we take stabilized patients off of medications that are working for them because they are no longer able to afford them, then are we not creating a real nightmare for ourselves?" asked Angela Ladner who is the Executive Director of Mississippi Psychiatric Association. "In the fact that they're going to have crisis."

Representative Gary Chism authored a bill aimed at stopping any problems the new plans may create.

"Blue Cross bullying tactics really harms health care in this state and we need to try to step in and do something," Chism said.

In it's statement, Blue Cross says the new provision encourages customers to use in-network doctors.

The House passed a bill that mandates insurance providers can't deny prescription coverage based solely on network status. That bill is now headed to the Senate.

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