Patients ‘in the middle’ as CareFirst, Johns Hopkins Medicine contract negotiations intensify

CareFirst BlueCross BlueShield, the region’s largest health insurer, and Johns Hopkins Medicine notified patients Thursday that coverage for some medical procedures and services could be eliminated if the two entities fail to negotiate a new contract by Dec. 5. At issue are the costs associated with the care patients receive in outpatient procedure areas and ambulatory surgery centers, or those that don’t require an overnight stay, as well as doctor and other providers’ fees. That means those with CareFirst insurance who need routine visits with doctors and minor surgeries, such as lens and cataract procedures or endoscopies, would be forced to pay out of pocket for those services. Hospital rates for inpatient services and procedures, meanwhile, are set by the state and are regulated; those rates are not up for negotiation in these discussions.