Governor's Ultimatum Looms for Anthem-Piedmont Contract

Precisely what executive action the governor could take remains unclear.

Atlanta-based Piedmont Healthcare and Blue Cross Blue Shield (BCBS) of Georgia have until the close of business Tuesday to resolve their contract dispute.

That ultimatum came Monday in a tweet from Gov. Nathan Deal, who warned "the state will be forced to initiate executive action" if the impasse continues.

Because the parties failed to reach an agreement by April 1, Piedmont physicians became out-of-network providers under the BCBS plans for about 650,000 state employees, retirees, and their families.

"We understand the disappointment of our consumers, as many of our own employees who receive care through Piedmont are also affected, and we are very disappointed by the disruption caused by Piedmont’s rejection of our offer," BCBS said in a statement.

Piedmont, however, accused BCBS of drafting written contracts that failed to match the verbal commitments the parties had reached before March 31. Physician compensation appears to be a key point of contention.

"What Anthem Blue Cross is offering our doctors does not even cover the annual rate of inflation, but they will tell you that we are asking for unfair rate increases," Piedmont said in a statement. "One only needs to look at the small community hospitals—across Georgia and the country—that are closing their doors to see why fair rates are important."

Precisely what executive action Deal could take if the Piedmont-Anthem contract remains unresolved past today's deadline is unclear. One possibility would be a "re-enrollment" period that would give state employees an opportunity to switch from BCBS to another insurer, as The Atlanta Journal-Constitution's Greg Bluestein reported.

But pulling the trigger on re-enrollment in the middle of a health plan year would be expensive, as Georgia State University health insurance expert Bill Custer told Georgia Health News.

Alternatively, Deal could direct officials to look into other means by which to promote competition among hospitals and insurers in the affected market.