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Hopkins, CareFirst reach a deal over insurance coverage

The Johns Hopkins Hospital, in Baltimore, in March 2020. Johns HOpkins and CareFirst BlueCross BlueShield announced an agreement that will avert an interruption in care for the health system's nearly 300,000 patients. (Rob Carr/Getty Images)

Johns Hopkins and CareFirst BlueCross BlueShield health insurance announced Wednesday they have settled a contract dispute, ensuring coverage will not be interrupted for nearly 300,000 patients that rely on the Baltimore-based health system.

Hopkins and CareFirst said last month they were at an impasse over rates the insurance company pays for care at Hopkins, a major provider of primary, specialized and outpatient surgical services in the region.

In a brief statement and video, Kevin W. Sowers, president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine, said Hopkins doctors, nurses, other caregivers and ambulatory surgery centers will remain in-network for CareFirst members.

“Thank you for your patience as we worked with CareFirst to come to this resolution,” Sowers said in the video.

A CareFirst spokeswoman said CareFirst and Hopkins officials would not agree to interviews or answer questions about the “financial and nonfinancial terms of the agreement.”

Hopkins last month announced its doctors, nurses and other health care providers would no longer accept CareFirst as of Dec. 5, which hospital officials said fulfilled their contractual obligation to give 90 days notice before providers leave the network.

The contract covers about 4,000 providers employed by Hopkins at the Johns Hopkins flagship hospital and Bayview Medical Center in Baltimore, as well as Howard County General Hospital in Columbia, Md., Suburban Hospital in Bethesda and Sibley Memorial Hospital in Washington. Providers at stand-alone ambulatory surgery centers, including those in Bethesda and Columbia, would also be affected.

In addition to the providers, Hopkins hospitals in Maryland were set to leave the network if Hopkins and CareFirst couldn’t reach an agreement by March 5, meaning hospital stays would not have been covered.

The dispute came just before the period of “open enrollment,” when many patients choose their health insurance for the coming year, adding to the pressure for CareFirst.

Hopkins and CareFirst officials previously said care could continue, even if no agreement were reached, for some people with severe illness, rare disorders or certain cancers, or for those who are enrolled in clinical trials.