After BCBS inks agreement with Nason, MEDcare waits for word

After BCBS inks agreement with Nason, MEDcare waits for word

CHARLESTON, SC (WCSC) - When he learned that BlueCross BlueShield of South Carolina had reached an agreement with Nason Medical Center to keep the urgent care provider on the insurance's primary network, Dr. Radwan Hallaba began checking his email.

Hallaba, a co-owner of Charleston-based MEDcare Urgent Care, was hoping he'd received some notification that a similar agreement might be coming for his facility.

"Not only can I tell you that there's no deal in the works, we've received no offer," Hallaba said on Friday afternoon, just hours after the announcement on the Nason agreement.

Hallaba said that MEDcare's founder, Dr. Joseph Pawlik, had been "back and forth" with the insurance giant since October, 2013, in an attempt to keep MEDcare in BlueCross's BlueChoice HealthPlan.

In the absence of that agreement, BlueCross customers will have to pay out of pocket if they choose MEDcare after Oct. 8 this year, when MEDcare will no longer be an in-network provider.

Part of the frustration for MEDcare leaders, Hallaba said, is the one big question that remains unanswered: why was the decision made?

Hallaba said BCBS has assured MEDcare that the decision to deselect them from the network was not related to any issues of cost, quality, convenience or BCBS's ownership of Doctor's Care.

"It has been vague. We were told this was a 'no cause termination," he said.

Hallaba said MEDcare learned of BlueCross's decision to deselect the provider in June.

On Monday, Charleston Mayor Joe Riley, H. Tim Pierce, president of the South Carolina Medical Association; and James Todd, business agent for Teamsters Local Union 509, all sent letters to the insurance company urging them to reinstate MEDcare.

Hallaba says Pawlik has handled the negotiations between MEDcare and BlueCross, but that as far as he knows, Pawlik hasn't heard anything about the possibility of an agreement that would put the facility back in the health plan network, either.

Late Friday afternoon, a spokesperson for BlueCross said they "continue to be in conversations with the leadership of MEDcare" but gave no indication whether a deal was imminent.

Copyright 2014 WCSC. All rights reserved.