"A clear violation of statutes governing the State and School Employees Health Benefits Plans as well as some state union contract language"
School Employees Health Benefits Plan Commission Hearing to be held March 23rd in Trenton
TRENTON, N.J., March 21, 2011 /PRNewswire-USNewswire/ -- A member of the Office and Professional Employees International Union Local 49/Clinical Social Work is protesting an action by Magellan Health Services that reduced by 35 percent the "allowable rates" for out-of-network therapists. Magellan Health Services, Inc. is the administrator of mental and behavior health services for Horizon Blue Cross/BlueShield of New Jersey, the plan that covers approximately 600,000 New Jersey State and local employees who will now be paying more for outpatient therapy.
A School Employees Health Benefits Plan Commission hearing on this case will be held on Wednesday, March 23 at 10:00 AM at 50 West State Street, Trenton, NJ. The Commission will then make its recommendation to the State Health Benefits Plan Commission.
Members of the press are encouraged to attend the hearing.
This reduction came without any warning whatsoever, and means that patients are now receiving 35 percent less from their insurance carrier and therefore paying substantially more than they anticipated and had been prior to this cut.
"This action by Magellan Health Services, Inc. is a clear violation of statutes governing the State and School Employees Health Benefits Plans as well as some state union contract language," said Luba Shagawat, Clinical Social Work Guild 49's Director of Legislative Affairs. "It appears to be part of an effort by the State of New Jersey Division of Pension and Benefits and Magellan Health Services, Inc. to reduce out-of-network usage for mental health, thus restricting the freedom of choice inherent in the plans. Since Magellan's profits increase when they pay less toward reimbursements, Magellan stands to gain financially through this effort." Rather than lower the cost of medical care, this strategy seems to be a tool to increase profits for Magellan Health Services, Inc. at the expense of government workers.
Office and Professional Employees International Union represents more than 108,000 members in the United States, Canada and Puerto Rico. The union represents employees in credit unions, hospitals and medical clinics, insurance, higher education, shipping, transportation, utilities, hotels, administrative offices and more.
Professional organizations and Guilds affiliated with OPEIU are a diverse group that includes physicians, registered nurses, pharmacists, chiropractors, appraisers, podiatrists, clinical social workers, hypnotists, teachers and helicopter pilots.
Members of the Press Are Encouraged to Attend the Hearing
SOURCE Office and Professional Employees International Union, AFL-CIO (OPEIU)