BCBSNC Mailing Out Provider Contract Addendum This Week

Your NCMS has held extensive discussions with Blue Cross Blue Shield of North Carolina (BCBSNC) to ensure that their latest  provider contract addendum satisfies the spirit of the fair contracting law passed last year. We can now report that the addendum has been finalized, and that BCBSNC began mailing the addendum to its network physicians yesterday. Physicians and practices should expect the addendum to arrive in their offices as soon as today. 

Accompanying the addendum is a cover letter that summarizes the changes being made to your agreement and the effective dates of the provisions.  The changes include a clear process for when BCBSNC proposes to modify your fee schedule and new notice contact provisions.

BCBSNC has been working on revisions since NCMS and its members raised objections to a previous addendum that was sent out in October 2009.

Previous articles on this subject

May 21, 2010:  BCBSNC Provider Contract Addendum Approved by DOI

May 7, 2010:  NCMS Dismisses Compliance Dispute With BCBSNC Over October 2009 Contract Addendum

April 23, 2010: DOI Disapproves Latest BCBSNC Provider Contract Addendum

 
 

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2 Comments

  • Conor

    Cathy,

    Previously the law provided no opportunity for contracting providers to object before an insurer modified reimbursement. An insurer could change your rates unilaterally and your only other option was to terminate the contract – a true “take it or leave it” proposition.

    The new law says that if insurers want to make a fee schedule change, they have to provide you 60 days advance notice, send you a copy of the proposed change, and allow you to object. If the parties are unable to come to an agreement, it’s then on the insurer to terminate, and not necessarily you.

    There are several other helpful provisions in the fair contracting law that you can review at http://www.ncleg.net/Sessions/2009/Bills/Senate/HTML/S877v5.html.

    Overall, it was a huge step towards leveling the playing field in the realm of managed care contracting.

    Conor
    NCMS

  • Cathy M. Poole

    How can the NCMS justify support of the “FAIR Contracting Law” passed last year?

    If physicians “OBJECT to BCBSNC Proposed Changes to their Agreement, the Proposed Change will not become effective, HOWEVER, BCBSNC MAY TERMINATE THE AGREEMENT”.

    And this satisfies the “SPIRIT OF FAIR CONTRACTING” ???
    Cathy M. Poole, Practice Administrator