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Insurance Commissioner Recinds BCBS contract amendements

Thursday, October 30, 2014   (0 Comments)
Posted by: David Waldrep
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Georgia Insurance Commissioner Ralph Hudgens has advised the Medical Association of Georgia (MAG) that he has told Blue Cross Blue Shield of Georgia, Inc. and the Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGa) that he will "immediately rescind recent amendments to its existing physician contracts."

Commissioner Hudgens says that the "action comes in response to numerous complaints from physicians (and their practices) regarding the insurer's amendments to existing contracts." 

He notes that, "I heard from physicians from all over the state about the heavy handed approach that was taken by Blue Cross regarding its contract changes...I want doctors spending time caring for their patients, not being stonewalled by an insurance company."

Commissioner Hudgens adds that, "This action resets the process while at the same time preserving the existing physician agreements without the amendments."  

He says that he will require BCBSGa to... 

•    File the proposed amendments with his office for review prior to implementation

•    Provide physicians (and their practices) with accurate and complete reimbursement schedules

•    Advise physicians/practices of any proposed contract amendments by way of certified mail and

•    Ensure that all contract changes comply with Georgia law

Commissioner Hudgens stresses that, "Once filed, the Department of Insurance will have up to 60 days to review the contract amendment for compliance with Georgia law."

He also emphasizes that, "The providers who are affected by the proposed amendment will continue to be in the Blue Cross network through their existing provider agreements."   

Of the development, MAG Executive Director Donald J. Palmisano Jr. says that, "This has been a critical issue for MAG on behalf of a lot of physicians in the state, so we applaud Commissioner Hudgens for his actions and his leadership." 



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