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Alvarado Hospital counters Blue Shield suit

Managed Care Weekly Advisor, September 5, 2007

A misunderstanding over the expiration of a contract has led to a drawn-out legal battle between Alvarado Hospital and Blue Shield, as the former denies that a contract remains in effect.

According to the San Diego Union-Tribune, Blue Shield has 35,000 members within 15 miles of the hospital, which was purchased from Tenet Healthcare for $22.5 million by pediatrician brothers Pejman and Pedram Salimpour. The suit states that in the weeks after the sale, Blue Shield attempted to negotiate lower reimbursement rates while declining the Salimpours' requests for higher payments. Two days after the hospital was sold, Blue Shield sought to extend the contract, and hospital officials refused.

The hospital continues to treat Blue Shield members who seek emergency care, but will not accept those seeking elective procedures.

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