Blue Cross Blue Shield of Georgia | WABE 90.1 FM

Blue Cross Blue Shield of Georgia

Ryan Nabulsi / twinlensatl.com

Anthem Blue Cross Blue Shield of Georgia is enacting a radical new policy on emergency room visits to contain costs.

The insurer, which provides the only Affordable Care Act exchange plan in well over half of Georgia counties, says they’ll carefully scrutinize medical records when its members go to the ER and, if it determines that a reasonable person with the same problem wouldn’t have made the decision to head to the hospital, it won’t pay the bill. Georgia hospitals and ER doctors are decrying the move, as are many consumers.

Andrew Harnik / Associated Press

Blue Cross Blue Shield of Georgia is proposing an average increase of 40 percent to insurance premiums on the individual marketplace next year through the Affordable Care Act. The proposed rate hikes come as Congress continues to debate health care.

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Andrew Harnik / Associated Press

Georgia’s largest health insurer is requesting an average premium increase of 40 percent for individual coverage in the Affordable Care Act insurance exchange next year.

Blue Cross Blue Shield of Georgia is the only health insurer scheduled to deliver a product in all 159 Georgia counties in the exchanges, which are designed to offer coverage to people who don’t get job-based or government health plans.

Brenna Beech / WABE File

The state insurance department says it will monitor the new emergency room policy of Blue Cross and Blue Shield of Georgia “to make sure that it is not abused to the disadvantage of Georgia policyholders.”

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In a Friday, May 6, 2016 photo, LSU medical student Felicia Venable, left, examines a patient as fellow students and medical residents observe during daily rounds at Our Lady of the Lake Regional Medical Center in Baton Rouge, La.
Gerald Herbert / Associated Press

Starting in July, health insurance provider Blue Cross Blue Shield of Georgia will stop covering emergency room visits it deems unnecessary.

And doctors and analysts have a lot to say about it. 

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Blue Cross Blue Shield of Georgia is enacting this policy because it doesn't want people to use the emergency room as their primary health care.  

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