ETMC Tyler Now Fully in Network with BCBS as Insurer Files Appeal

TYLER – Blue Cross Blue Shield has filed an appeal of the November 12 injunction that granted in-network provider status to Tyler’s East Texas Medical Center. The hospital’s president/CEO, Elmer Ellis, feels the appellate court will uphold the injunction. Ellis said in a news release, “We expected that the appeal would be filed, and we are confident that consumer choice will be protected as the legal process continues.” Ellis said the filing the appeal does not change ETMC Tyler’s in-network status. ETMC has now fully transitioned to an in-network hospital in the Blue Cross Blue Shield preferred provider organization. According to Blue Cross Blue Shield, 30,000 East Texans in Smith County alone are now covered under its PPO network.

Earlier this year, ETMC filed suit in excess of $1 million against three of the largest health insurance carriers in East Texas. A news release at the time claimed that the hospital’s exclusion from the preferred provider networks (PPO) of these companies has created serious and negative consumer impacts. The insurance companies named in the suit are Blue Cross & Blue Shield of Texas, a division of Health Care Service Corporation; Aetna Health, Inc., Aetna Life Insurance Company; Cigna Healthcare of Texas, Inc.; and Cigna Health and Life Insurance Company. The hospital argued in its suit that its exclusion lessens consumers’ choice of quality health care providers and increases healthcare costs for some patients. The suit also states that the exclusion of ETMC Tyler is contrary to the provisions of the Texas Insurance Code. Blue Cross Blue Shield has not responded to a request for comment made earlier by KTBB.