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A resolution approving an ancillary provider agreement between the Metropolitan Government of Nashville and Davidson County, acting by and through the Metropolitan Board of Health, and BlueCross BlueShield of Tennessee, Inc., to provide healthcare services to individuals eligible to receive covered services under a BlueCross benefit plan.
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WHEREAS, the Metropolitan Public Health Department is a provider of professional healthcare services; and,
WHEREAS, BlueCross BlueShield of Tennessee, Inc. issues and administers benefit plans covering the provision of healthcare services to individuals eligible to receive covered services under a BlueCross benefit plan; and,
WHEREAS, Metropolitan Charter Section 10.104 provides that the Board of Health has the duty to contract for such services as will further the program and policies of the board, subject to confirmation by Resolution of Council; and,
WHEREAS, the Metropolitan Government, acting by and through the Metropolitan Board of Health, and BlueCross BlueShield of Tennessee, Inc. desire to enter into this ancillary provider agreement for the Metropolitan Public Health Department to provide healthcare services to individuals eligible to receive covered services under a BlueCross benefit plan; and,
WHEREAS, it is to the benefit of the citizens of the Metropolitan Government of Nashville and Davidson County that this ancillary provider agreement be approved.
NOW THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE METROPOLITAN GOVERNMENT OF NASHVILLE AND DAVIDSON COUNTY:
Section 1: That the ancillary provider agreement between BlueCross BlueShield of Tennessee, Inc., and the Metropolitan Government of Nashville and Davidson County, acting by and through the Metropolitan Board of Health, to provide healthcare services to individuals eligible to receive covered services under a BlueCross benefit plan, a copy of which is attached hereto and incorporated herein, is hereby approved.
Section 2: That this Resolution shall take effect from and after its adoption, the welfare of The Metropolitan Government of Nashville and Davidson County requiring it.
Agenda Analysis
Analysis
This resolution approves an ancillary provider agreement between the Metropolitan Board of Health and BlueCross BlueShield of Tennessee, Inc. (“BCBST”).
Pursuant to this agreement, the Metropolitan Public Health Department (“Health”) would become an in-network provider with BCBST members, meaning Health could provide healthcare services to individuals eligible to receive covered services under a BCBST benefit plan. Health would agree to participate in BCBST’s Blue Network P and Blue Network S.
The term of this agreement is three years, with the option to renew for successive periods of one year, up to a total term of five years. Neither party could terminate the agreement without cause during the initial three-year term of the agreement, but either party could terminate without cause upon 120 days written notice after the first three years.
Metropolitan Charter Section 10.104 states that the Metropolitan Board of Health has the duty to contract for such services that will further the program and policies of the board, subject to approval by resolution of the Metropolitan Council.
Fiscal Note: Metro will receive reimbursement for covered healthcare services provided to eligible members of BlueCross Blue Shield of Tennessee, Inc.