Blue Cross Blue Shield, EAMC Destroying Healthcare System in Alabama

Bad news for residents of Chambers County was broken by a carefully worded press release which artfully announced that inpatient medical services would no longer be available at East Alabama Medical Center EAMC-Lanier Hospital in Valley. According to the release "Officials from East Alabama Health have submitted an application to the Centers for Medicare and Medicaid Services (CMS) requesting that EAMC-Lanier be designated as a Rural Emergency Hospital." Centers for Medicare & Medicaid Services are described on their official website as "the federal agency that provides health coverage to more than 160 million through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace." Providing context on the REH designation, CMS states on their website "On November 23, 2022, we published a final rule, effective January 1, 2023, establishing initial policies for Rural Emergency Hospitals (REHs) as a new Medicare provider type enacted in the Consolidated Appropriations Act (CAA) of 2021."

"REHs are prohibited from providing inpatient services" is the key statement from that article on the CMS website, in case there was any doubt as to what this designation truly entails. Anger was palpable in the reactions on social media from Chambers County residents who voted on Election Day 2022 to renew their payment of an ad valorem tax to support EAMC-Lanier. Since that tax had first been established several years prior, citizens of Chambers County have paid $8.7 million to East Alabama Health Care between 2014 through 2021 to keep the Valley hospital open without any service cuts. Here is a sample of facebook comments regarding the bait and switch that EAMC pulled to drum up support for the tax while secretly planning to stab Chambers County in the back;

Wonder if they will remove the ad valorem tax that was voted in to save the hospital?

they should it but bet it will not ...but eamc appreciated it greatly. Not to mention I think this was the plan all along....so sad.

Good point. I hope EAMC keeps it open for at least outpatient and emergency services. I am not surprised. But very sad that we are losing our hospital a little piece at a time.

yep...but they have been slowly removing services a little at a time..lanier is just a shell of what it use to be.

I agree. It started when they removed OB services so no more babies were born in Chambers County. So sad.

they won't...that was what eamc was waiting to happen before they bought out lanier...they did it right after the vote to approve that tax.

This doesn't surprise me. When I left the job at the hospital they were cutting as many corner as they could. From running the bare minimum crew for the hospital to closing positions they could cut. That hospital is a joke tbh

I love EAMC Lanier. It has ben a very good hospital for a long time. I am very sad to see the inpatient services be cut out. This will undoubtedly be cutting jobs also. Very sad for our area.

the employees there are great. It's the administration is what the issue is. They are all about saving the pennies where they can. When I worked there we were always short on supplies in the area I worked, from food for the patients, to patient clothing to sometimes even medical items. It was a very poorly kept hospital.

wouldn't doubt it, EAH is struggling and it's best days are behind them. They mishandled the covid funds and didn't invest in any of their staff, just lined board members pockets and brought in thousands of travel nurses paying them $75/hr while keeping their MCTS at $9 and nurses at $18 and worked them to death. That's why they have staffing issues now

Amen! With EAMC moving more and more services to Opelika, we may as well just go to Opelika. I sure won't vote for the tax again.

Further details on the matter will be put forth as they become available for in-depth analysis, however, there is plenty of context readily available as to why EAMC would be so desperate to cut costs in such a reckless manner. As with every other shameful aspect of Alabama's pitiful healthcare system, all roads lead to downtown Birmingham and the corporate offices of Blue Cross Blue Shield of Alabama when seeking out the money lusting culprits. In search of a master manipulator with his slimy tentacles spread across the state, one look no further than the BCBSAL head honcho.

If BSBCAL is the corporate cartel directing the medical mafia families of Birmingham, then Vines is their Pablo Escobar. When you hear the word "monopoly", the legendary board game might be the first thing to come to mind until you look at how BCBSAL has spent decades running Alabama's healthcare system into the toilet in their maniacal pursuit of blood money. Studies conducted by the American Medical Association in 2012, 2018 and 2022 consistently ranked Alabama as having the least competitive health insurance market in the entire nation thanks to BCBSAL and their criminal empire.

In a 2012 AL.com article reflecting on the infamous ranking by the AMA, some worrisome implications were pondered at length.

Alabama is No. 1.

But in this category -- the least competitive commercial health insurance market -- that's not a good thing --at least for patients and doctors, according to a report released today by the American Medical Association.

A study of U.S. markets found that a single insurer -- Blue Cross Blue Shield of Alabama -- accounts for 88 percent of Alabama's commercial health insurance market.

According to the study, this anti-competitive environment hurts patients and doctors because of higher premiums, watered-down benefits and insurers' growing profitability.

"It appears that consolidation has resulted in the possession and exercise of health insurer monopoly power," according to the study.

Industry leading website Insurance Forums had some frightening takeaways on the 2018 AMA study.

Decades of undue influence wielded by BCBSAL over healthcare in Alabama have seen the chickens coming home to roost in 2024 as reflected in this Reuters article from February detailing the ungodly monetary sum that they have extracted from the state's economy.

Blue Cross Blue Shield Association must face claims that it schemed with affiliates for years to underpay healthcare providers by billions of dollars, a federal judge in Birmingham has ruled.

U.S. District Judge R. David Proctor in a ruling, on Wednesday said non-hospital health providers in the state could proceed toward a trial, marking the latest blow to Blue Cross in the long-running litigation.

Dozens of insurance subscriber and healthcare provider cases were centralized in Alabama a decade ago as part of a multidistrict litigation proceeding. The lawsuits alleged a conspiracy among Blue Cross and its members to curb competition, driving up the cost of insurance and driving down reimbursements.

The providers "presented evidence of actual injury as a result of the alleged conspiracies,” Proctor said in denying Blue Cross's bid for summary judgment.

Proctor had previously allowed claims from more than 100 hospitals in Alabama to move forward to trial.

A lawyer for the health providers, Joseph Whatley, said on Wednesday that the decision clears the path for trial.

“We look forward to presenting all the issues for all healthcare providers to a jury,” Whatley said. The court has not set a trial date.

Experts for the Alabama hospital plaintiffs have estimated that they suffered more than $5 billion in damages, court filings show. The non-hospital providers have not specified their individual damages.

The healthcare providers' claims was part of broader litigation against Blue Cross and its affiliates over their business practices.

A class of insurance subscribers, including individuals and companies, settled related claims against Blue Cross for $2.7 billion in 2020.

That settlement won approval last year in the Atlanta-based 11th U.S. Circuit Court of Appeals.

Policyholders accused the association and member plans of agreeing not to compete with each other, in violation of U.S. antitrust law. The first complaint was filed in 2012.