Piedmont adjusts to changes made to state plan

by Clay Neely - clay@newnan.com

As Georgia plans to spend about $114 million to restore some benefits to the health plan covering teachers and state employees, the state Department of Community Health's board voted to revert to offering small co-payments for health services and drugs to the 650,000 state workers, retirees and dependents covered by the plan.

The agency changed the plan last year to end the co-payments in an effort to save the state money. Teachers and state workers argued they would be forced to pay higher out-of-pocket costs starting Jan. 1.

“We have received calls from local teachers and other state employees, including retired state employees who are confused over the coverage their plan provides,” said Kelly Hines, director of public relations and communications for Piedmont Newnan Hospital.

“Piedmont hospitals and physicians accept patients who are covered by the State Health Benefit Plan — current state employees and retired state employees,” said Hines. According to Hines, hospitals and physicians without a Medicare Advantage contract with Blue Cross Blue Shield are not listed in the in-network provider list for retirees. But, it is an open-access plan, she said, and the guide states retirees can go to any out-of-network provider accepting Medicare.

“Retirees with the State Health Benefit Plan will have no problem accessing Piedmont hospitals and physicians, and there will be no out-of-network penalty associated with the visit,” assured Hines.

The governor's office said co-pays will become effective March 14, but will be applied retroactively to Jan. 1.

Tracey Nelson, director of government relations for the Georgia Association of Educators, said in a statement that the organization has lingering questions about a lack of provider options and coverage throughout the state.

The Georgia Democratic Caucus released a statement saying changes to the plan don't go far enough and don't offer enough provider options.

A bill introduced by State Sen. Vincent Fort, D-Atlanta,would require DCH to offer at least two provider choices, caucus members said adding that the plan currently provides coverage under Blue Cross Blue Shield of Georgia.

(The Associated Press contributed to this report.)

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