November 03, 2009
Blue Cross Blue Shield of Alabama announced on Nov. 3 that it will delay the implementation of its recently announced fee schedule, which was originally scheduled to go into effect on Dec. 1. At this time the anticipated effective date for the new BCBS fee schedule will be no later than July 1, 2010. More details about the new payment methodology is to be posted on the BCBS Web site.
When the new fee schedule was released to physicians on Sept. 1, BCBS officials estimated that approximately 40 percent of Alabama physicians would see an overall decrease in payments, and some specialties have projected reductions approaching 20 percent. Over the past few weeks representatives of several specialty societies have met with BCBS and requested that the fee schedule be delayed, and multiple physician organizations and individual practices have filed complaints with the Compliance Dispute Facilitator for the BCBS Class Action Settlement. On Oct. 23 MASA learned that a delay in the fee schedule implementation date was being considered. Because the new fee schedule also included a much needed increase in payments for primary care services, MASA contacted the BCBS leadership and encouraged them to implement those increases December 1 as planned.
Although BCBS representatives have assured MASA the announced E&M fee increases will not be reduced when the new fee schedule goes into effect, they indicated that BCBS was unwilling to make those increases effective on Dec. 1 as previously announced until the impact of the meetings with specialty societies and the compliance dispute process is known.
On Thursday, Oct. 29, MASA leadership held a second conference call with presidents and executives of county and specialty societies. Ms. Winegard, the Court appointed Compliance Dispute Facilitator, also participated in the call. She informed the group that in addition to the complaint filed by MASA, she had received severalcomplaints filed by specialty societies and individual physicians. It was decided that a Task Force comprised of those who have filed complaints will be formed. The Task Force, led by MASA and with the assistance of Ms. Winegard, will monitor the complaint dispute process with BCBS.
MASA continues to encourage specialty societies to meet with BCBS in an effort to explore opportunities to resolve specialty specific issues. The opportunity to meet with BCBS is available to every specialty society, regardless of the projected impact of the new fee schedule for its members, and is not limited to those specialties which have filed complaints with the Compliance Dispute Coordinator.