NCMS Keeps Watch over Developments Involving BCBSNC Contract Addendum

On October 1st, most Blue Cross Blue Shield of NC (BCBSNC) participating providers were sent a contract addendum explaining changes to their existing contract that BCBSNC stated were necessary in order to comply with SB 877 passed in August of 2009.  This addendum had been expedited by the Department of Insurance (DOI) at the request of BCBSNC and mailed in order to provide providers with ninety days notice before the new law would go into effect on January 1. 

Recently, BCBSNC invited representatives of the provider community to meet with them about a second filing that they had sent to the DOI on November 6th.  DOI withdrew approval of the first filing on November 9th.  According to the DOI, however, the first addendum, if it was sent out after approval but before approval was withdrawn by the DOI, remains effective.  The second filing, which you can read here, makes some significant changes but still fails to meet the full intent of the new fair contracting law. 

The second filing continues to be under review by the DOI.  NCMS is working to ensure that any further addendums or changes to the BCBSNC contract will fully comply with two specific pieces of the new law.

  • Clear request for a notice contact for all communications regarding fee schedule changes
  • Notice with a negotiation period before any fee schedule changes or termination can take effect

The legislature viewed these elements as fundamental fairness within a contract negotiation.  NCMS will continue to work with leadership within the DOI and the NC General Assembly to ensure that insurers will fully comply with this law.

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