Physicians protest N.C. Blues contract change

Doctors believe the plan was trying to preempt a law barring unilateral changes that will take effect in January 2010.

By Emily Berry — Posted Nov. 24, 2009

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Blue Cross and Blue Shield of North Carolina has backed away from a contract addendum it sent to physicians in September, a move that follows objections raised by the North Carolina Medical Society and others.

But it's unclear whether a new draft will assuage physician concerns.

The medical society, the North Carolina Blues and the state insurance commissioner were planning to meet in late November to discuss the plan's proposed contract changes, but as of Nov. 12, the medical society hadn't seen a draft of the agreement.

The state's medical society, along with the North Carolina Medical Group Managers Assn., the North Carolina Academy of Family Physicians and the North Carolina Society of Anesthesiologists, wrote a letter to state Insurance Commissioner Wayne Goodwin Oct. 26 asking him to intervene to protect doctors from the changes the Blues plan proposed in September (link).

The groups said they believe the changes were made to avoid provisions of a new contracting law set to take effect Jan. 1, 2010.

According to the physicians' letter, the addendum said the Blues could change doctors' fee schedules whenever the plan wanted, and that doctors would be terminated from the network if they objected.

A law signed July 17 by Gov. Bev Perdue requires health insurers to notify physicians of changes to their contracts. It gives doctors the option to object to the changes and terminate the contract if they wish.

NCMS spokesman Mike Edwards said the medical society was told later that the North Carolina Blues withdrew its original addendum, and that Goodwin, the Blues and the medical society were searching for a meeting date to discuss details of the new draft.

The insurance commissioner has the authority to accept or reject insurers' contract revisions.

In an e-mailed statement, North Carolina Blues spokeswoman Kimberley Colvin said, "BCBSNC was in full compliance with our negotiated provider contract agreement and already complies with most of these provisions in the new legislation, but has amended its contracts to ensure compliance with this new legislation."

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