Eye doctor Patricia McLaughlin has been blindsided by ObamaCare — twice.
The Upper East Side ophthalmologist just got word that Empire Blue Cross Blue Shield has excluded her from its network of doctors to serve patients enrolled in its new individual and small-group medical policies under the Affordable Care Act.
That means her patients who join the new policies will have to pay entirely out of pocket if they want to keep her as their doctor.
McLaughlin expects an uproar when patients find they can no longer see their regular doctor.
“There’s going to be mass confusion come January,” she said.
It was the second ObamaCare shock for the doc, who had previously gotten a letter from Empire Blue Cross telling her it had canceled its coverage of her own four-person office to comply with ObamaCare. She expects to pay more for a new policy now.
“I have a double whammy. I lost my insurance. Now my medical practice is going to be losing patients,” McLaughlin said.
She expects to lose 20 to 25 percent of her patients.
Empire sent McLaughlin a “network exclusion notification” Oct. 29 saying she’s not on the doctors list for its new Pathway policies offered through the New York health exchange.
“This letter is to notify you that consistent with the terms of your agreement, Empire is not able to extend participation in the Pathway Enhanced Network or Pathway Network to you at this time. This means that you will be considered a non-participating provider in both,” wrote John Caby, the insurer’s vice president for provider contracting.
The letter doesn’t specify why McLaughlin is being shut out while she is listed as a preferred provider under other plans.
Empire declined comment.
Industry insiders say insurers are under pressure to offer cheaper rates for ObamaCare plans and are narrowing their networks of doctors to cut costs.
“You have to be competitive,” said a source with one insurer.
But McLaughlin insists doctor-cutting won’t improve care.
“For a number of people, losing their doctor will be a horrific loss. There are patients who are attached to me,” she said
“Our hearts are somewhat broken. The doctors’ major concern is the well-being of the patient, access to care for the patient. We know more than the public. To me, the network is everything.”