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British health insurer Bupa says their patients remain fully covered after Healthscope cancelled contracts with them and 22 other Australian Health Service Alliance-allied insurers.
Bupa says the full coverage at Healthscope hospitals will remain until at least February 20, 2025, and possibly beyond for some treatments.
Healthscope said their contract with Bupa will terminate on February 20, 2025, with a March 4, 2025, termination date for AHSA funds, which includes Australian Unity, GMHBA, Health Partners, Westfund and HIF.
The move is reported to affect six million people and 38 hospitals, according to media reports.
“Since March, Bupa worked tirelessly to engage constructively with Healthscope and negotiate amendments that they requested to our current contract,” Bupa APAC CEO Nick Stone said.
“We are shocked and deeply disappointed by Healthscope’s action.”
He said that Bupa had signed a three-year contract with Healthscope as recently as November 2023.
“Last month, Healthscope announced it would attempt to charge Bupa and AHSA members … an additional out of pocket ‘hospital facility fee’ with no further benefit to customers,” Stone says.
Healthscope had earlier announced that as of November 26, fund members would incur a hospital fee of $100 for overnight patients per admission and $50 for same-day patients per admission.
Stone says Bupa is now exploring its options.
HEALTHSCOPE
Healthscope said the cancellations are the result of legal threats from insurers to block the fee.
Their CEO, Greg Horan, says the insurers’ refusal to accept the fees had left it with no option but to issue the termination notices.
“We were proposing the hospital facility fee following Bupa’s and the AHSA’s failure to recognise and fairly fund the rising cost of care. In the absence of fair funding, this fee was Healthscope’s best option,” he said.
“The response from the insurers was lawfare, and we are not prepared to engage in protracted and expensive legal challenges.
“In order for us to remain viable, we are left with no choice but to terminate the contracts.”
Mr Horan said he was deeply disappointed by the insurers’ opposition to the fee.
“There is a viability crisis impacting private hospitals across the country,” Horan says.
“Hospitals are losing money and cannot attract new investment. Private health insurers are banking record profits …”.
Both Bupa and Healthscope say they are still willing to negotiate a “fair” agreement.
