Oct 07, 2024
[OCTOBER 7, 2024] Florida Blue has signed a new multi-year agreement with Baptist Health. Most members have continued access to care with Baptist Health providers and facilities. The exceptions are as follows:
- The new agreement excludes myBlue/myBlue Connected Care members, so they are now out-of-network with Baptist Health. However, if necessary medical services are provided at Wolfson Children's HOspital, they will be covered by myBlue and myBlue Connected Care.
- Medicare Advantage members will no longer have Baptist Health PCPs in their network. However, they will be able to receive in-network care from Baptist Health specialists and at Baptist Health facilities.
Most members will be sent a letter to let them know that Baptist Health is staying in their network. HMO members will be moved back to their assigned Baptist PCP unless they have already self-selected a new PCP. If a member isn't moved back automatically, instruct the member to call Florida Blue using the number on the back of their I.D. card.
[SEPTEMBER 16, 2024] An email was sent to members from Darnell Smith, North Florida Market President. The email restates Florida Blue's commitment to its members and their communities. It reiterated that they will continue paying for claims at services rendered at Wolfson Children's Hospital should Baptist leave the network; they are currently seeking a letter of agreement with Baptist Health to ensure this happens. The email also updates members about Florida Blue's current negotiating position.
The following hospitals are affected by these contract negotiations:
| COUNTY | FACILITY NAME | FACILITY ADDRESS |
|---|---|---|
| Clay | Baptist Medical Center Clay | 1771 Baptist Clay Drive Fleming Island, FL 32003 |
| Duval | Baptist Medical Center | 800 Prudential Drive Jacksonville, FL 32207 |
| Baptist Medical Center Beaches | 1350 13th Avenue South Jacksonville Beach, FL 32250 | |
| Baptist Medical Center South | 14550 Old St. Augustine Road Jacksonville, FL 32258 | |
| Wolfson Children's Hospital Claims at this provider will be paid; see update from 09/16/2024. | 800 Prudential Drive Jacksonville, FL 32258 | |
| Nassau | Baptist Medical Center Nassau | 1250 South 18th Street Fernandina Beach, FL 32034 |
In addition, the following physician groups will also be out of network:
| PROVIDER GROUP NAME | FLORIDA BLUE PROVIDER NO. |
|---|---|
| Baptist AgeWell Physicians, Inc. | 004X8 |
| Baptist ENT Specialists, Inc. | 001TA |
| Baptist Heart Specialists | 002SW |
| Baptist MD Anderson Cancer Physicians, Inc. | 004Q2 |
| Baptist Neurology, Inc. | 0005U |
| Baptist Obstetrics and Gynecology, Inc. | 00A4S |
| Baptist Primary Care, Inc. | 45274 |
| Baptist Pulmonary Specialists, Inc. | 00A4G |
| Baptist Specialty Physicians, Inc. | T9KOE |
| Baptist Urology, Inc. | 004JE |
| Lyerly Baptist, Inc. | 77969 |
Florida Blue estimates that a total of 24,704 HMO members will be required to have a PCP reassignment if these facilities become out-of-network providers. Members will be automatically reassigned, and if affected, will receive information about the PCP change in August 2024. This information will include instructions for members to select their own new PCP if they wish to do so.
Members and employers who wish to understand what other in-network hospitals and providers are available, if this negotiation does not end in agreement, can do so by visiting the Florida Blue web site or by calling the number on the back of their member ID card.
If the negotiation does not succeed, continuity of care will be available for members in active treatment.
[AUGUST 13, 2024]: As of August 9, 2024, Florida Blue and Baptist Health Jacksonville remain in negotiation. However, no agreement has yet been reached. If an agreement is not reached, the contract with Baptist Health will expire on October 1, 2024.
For this reason, Florida Blue has begun sending pre-termination notifications to all members who have been treated by a Baptist Health provider during the claims six-month utilization lookback. Letters are being sent to approximately 60,180 members and began arriving on August 7, 2024.
Pre-termination letters are also being sent to employer groups in Baker, Clay, Duval, Nassau, Putnam, and St. Johns counties.
Reminder: if a member's group is on the Sales Do Not Mail List, the member will not receive a pre-termination notification.
[JUNE 14, 2024] Florida Blue is in contract negotiations with Baptist Health Jacksonville (Baptist Health) in Northeast Florida, which operates multiple acute care hospitals, emergency rooms, physician groups, and other specialty health care services throughout Northeast Florida. Baptist Health has been a longstanding provider partner, and Florida Blue is currently negotiating in good faith. If an agreement is not reached, Baptist Health could become an out-of-network provider beginning October 1, 2024.
For questions, further information, or talking points, contact your Amwins Connect Regional Sales Manager.
