BlueCross BlueShield of WNY cutting Medicaid programs

BUFFALO, NY-- BlueCross BlueShield of WNY says they will no longer offer medicaid programs effective October 31, 2014.

The company says they have incurred losses of over $40 million over the past three years due to underfunding by New York State. The BlueCross BlueShield of WNY Vice President and CFO stated in a press release that the funds BCBS receives from NYS for reimbursment are less than what they are paying for patient medical and pharmacy claims.

About 53,000 WNY residents in Erie, Cattaraugus, Chautauqua, Orleans, Wyoming and Allegany counties will be affected.

Here is the full statement from BlueCross BlueShield of Western New York Executive Vice President, Chief Financial Officer Stephen T. Swift:

BlueCross BlueShield of Western New York administers a variety of New York State health care programs (Medicaid) to 53,000 individuals in six Western New York counties (Erie, Cattaraugus, Chautauqua, Orleans, Wyoming, and Allegany).

We have a long history of supporting these programs and members. However, in spite of significant efforts to address chronic underfunding by New York state, we have incurred losses in excess of $40 million over the past three years. The premium dollars we receive from the state continue to be insufficient to cover the medical and pharmacy claims we pay for our members' care.

After considerable deliberation and due diligence, BlueCross BlueShield of Western New York has made the decision to no longer offer Medicaid programs in these six counties effective October 31, 2014.

BlueCross BlueShield has provided formal notice to the New York State Department of Health of this decision. An orderly transition of our members affected by this decision to another health plan is our first priority. We are committed to working with the state to assure that the withdrawal process is implemented in a manner that minimizes the impact on our members.

We have a long history of supporting these programs and members, however, we cannot continue to incur losses of this magnitude, which ultimately must be funded by other lines of business.

Decisions like these are never easy, but we are faced with an unsustainable model that left us no choice but to proceed with a responsible exit from these programs and transition of membership to another health plan.


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