On October 26, 2009, NCMS, as part of a coalition of physician organizations, sent a letter to the Insurance Commissioner outlining major problems with the BCBSNC contract addendum. BCBSNC subsequently filed a revised addendum with the Insurance Commissioner in an effort to address some of these concerns. While the revised addendum contained a few improvements, it still fell short of the requirements of SB877. On December 18th, NCMS sent a second letter to the Insurance Commissioner outlining concerns with the revised addendum. Insurance Commissioner Wayne Goodwin subsequently denied approval of the BCBSNC revised addendum.
The settlement agreement that resolved the class action against Blue Plans and a number of state medical associations (including NCMS) contains provisions that require BCBSNC to comply with state law. Based in part on our belief that the addendum distributed by BCBSNC on October 1, 2009 is inconsistent with SB877, the NCMS has filed a compliance dispute under the settlement agreement. The compliance dispute alleges timeframe violations of notice requirements, overreaching exceptions to notice requirements for fee schedule changes, failure to conform to relevant provisions of the settlement agreement, and failure to follow state law. We will keep our members apprised of developments in this area.