State’s first ‘freestanding ER’ will close amidst dispute over reimbursements
WEST WARWICK — Rhode Island’s first freestanding emergency room, Neighbors Emergency Center at 325 Quaker Lane, will be closing its doors for good on August 4. Although West Warwick was proud to call the relatively new business one of its own, CEO Dr. Setul Patel confirmed this week that the the Houstonbased company will be shutting down its operations in West Warwick and has halted plans for a potential new location in Bristol, citing a disagreement with Blue Cross Blue Shield of Rhode Island.
According to Neighbors PR Specialist Denise Hahn, the closing will effect nearly 30 employees and is the direct result of Blue Cross Blue Shield of Rhode Island’s “refusal” to recognize Neighbors as a freestanding emergency center despite the fact that they applied for a license with the Rhode Island Department of Health as such.
“Blue Cross Blue Shield of Rhode Island’s is refusing to reimburse Neighbors as the emergency medical provider it is,” Hahn said.
The location opened in the fall of 2016 not long after Gov. Gina Raimondo signed legislation introduced by Rep. Patricia Serpa and Sen. Josh Miller making freestanding ER’s subject to the same regulatory requirements as other health care facilities. The Rhode Island Department of Health approved their license in April 2016.
Neighbors claims they were wrongly being charged the same rates as those of an urgent care facility, noting they provide emergency treatment for things that are not necessarily addressed in an urgent care setting such as a heart attack or stroke.
Reached for comment, BCBSRI said that Neighbors is not a hospital and is therefore subject to a different reimbursement.
“To keep healthcare affordable for our customers, BCBSRI must ensure that all of our contracts with providers are fair and financially sustainable,” said Jill Flaxington, PR Specialist for BCBSRI. “While the law requires us to reimburse outof-network hospital emergency departments comparable to in-network emergency department rates, because Neighbors Emergency Center is not a hospital it is subject to a different reimbursement.”
Flaxington also said that BCBSRI offered Neighbors an in-network provider contract but did not receive a response.
“We remain open to entering into an in-network contract that ensures affordability for Blue Cross customers,” she said.
Many people liked the West Warwick facility but were not able to be seen because of restrictions on which insurance plans are accepted. At the federal level, freestanding emergency rooms are still not recognized and therefore Neighbors cannot be reimbursed for Medicare and Medicaid costs, forcing them to turn many patients away.
“Neighbors is proud to have been the first freestanding ER in Rhode Island,” said Hahn. “And we are grateful to the dedicated doctors, nurses and staff of the West Warwick center. They were always committed to the Neighbors purpose of making lives better and did great work in their community taking care of patients and providing faster, better ER care that the people of Rhode Island deserve.”
The facility was the first of Neighbors’ locations to open outside of Texas, where the majority of their 31 ERs are situated. The 24-hour center offered an on-site laboratory, around-the-clock access to imaging services like X-Rays, CT scans and ultrasounds, short wait times and a personalized experience with healthcare.