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Listen Now: Morning News

Ambulance authority and Highmark BlueCross/BlueShield go through months of negotiations before contract renewal

CHARLESTON, W.Va. — It was no simple process for the Kanawha County Ambulance Authority and Highmark Blue/Cross/BlueShield to make a deal.

It was announced last week that the two had finally reached a contract agreement on Highmark’s reimbursements for ambulance services.

Prior to the agreement, KCEAA announced that it was going to cancel its contract with Highmark altogether once the prior contract expired on January 1, 2026. This would have made those with Highmark BlueCross/BlueShield pay out of pocket for ambulance services going forward.

KCEAA spokesman Tom Susman said discussions picked up once the notice of cancellation was given.

Tom Susman

“The issue was that it costs a certain amount to deliver ambulance services in this county, and the level of reimbursement we were getting from Highmark was below that cost and we needed to readjust those rates. I don’t believe they were in a position that they wanted to do that, so if you can’t make it work, then you basically have to decide how you want to proceed and the authority decided to give them a notice of cancellation,” Susman said on “580 Live” with Dave Allen on WCHS Radio.

“We kind of went back and forth for about a month and a half and finally came to an agreement,” he continued.

Susman says it was not always pretty, but the two sides came to a good enough compromise.

“We’re fine. You go back and forth. It’s a normal negotiation. They get mad at you, and you get mad at them,” he said.

“Did we get everything we wanted? No. Did they get everything they wanted? No. So, I guess it’s a good agreement.”

According to Susman, the deal with Highmark has sparked other necessary conversations.

“What has also been another nice by-product is we’ve heard from other insurance companies that we were going to go and to talk about contracts, so it’s really opened the door for multiple contracts with different insurance companies,” he said.

Susman did not share any financial details regarding the new contract.





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