Talks Progress in Lawsuit Between HealthAlliance and Empire Blue Cross

KINGSTON – Talks in the $10 million lawsuit between HealthAlliance of the Hudson Valley and Empire Blue Cross/Blue Shield have made “significant progress,” Ulster County Executive Mike Hein said Monday.

“I firmly believe there has been significant progress, but progress alone is not enough. There needs to be a resolution of this in a timely fashion,” Hein said.

“We will continue to put pressure on and examine all our options, and we will take action if there is gridlock.”

The dispute is anchored in the takeover of HealthAlliance of the Hudson Valley by the Westchester Medical Center network on March 30.

That was one day before the deadline outlined in Westchester Medical Center’s agreement with Empire Blue Cross/Blue Shield.

That agreement specified reimbursement levels. In particular, the pact provided for higher insurance reimbursements than the separate agreement between HealthAlliance and Empire Blue Cross/Blue Shield, according to court documents.

Westchester wanted Empire to pay the higher rate; the insurance company objected, saying that Westchester had not fully “acquired” the HealthAlliance system, which includes campuses on Broadway and St. Mary’s Avenue in Kingston and the Margaretville Hospital.

The upshot: Empire dumped HealthAlliance from its network, which meant patients with Empire insurance had to pay higher rates for care under HealthAlliance or drive to in-network facilities in Dutchess County or elsewhere.

That affected 4,000 Ulster County employees and numerous other local residents.

In May, Westchester sued on behalf of HealthAlliance.

Westchester is asking for a minimum of $10 million to cover losses and in-network status for HealthAlliance.

There has been no resolution to date, despite the calls from, among others, Assemblyman Kevin Cahill of Kingston, chair of the Assembly Insurance Committee, and Hein.

Lawyers in the case did not return calls for comment.

The court schedule for the case says they are compiling and filing depositions as part of discovery in the case.

The deadline for that alone is not until June 30.

But, as Hein pointed out, “Nothing is precluding the parties from negotiating and coming to a resolution sooner.”

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