CMA has formally requested that the Department of Managed Health Care step in and delay implementation of Blue Cross fee schedule changes that are scheduled to take effect June 1. Blue Cross has failed to provide physicians with timely access to the proposed fee schedule, leaving many physicians unable to assess the financial impact that the fee schedule changes will have on their practices.

CMA believes that Blue Cross is in violation of state law, which requires insurers to fully disclose to contracting physicians their fee schedules and payment rules and to notify physicians in writing 45 days before instituting any changes to fee schedules and payment rules. CMA also believes Blue Cross is in violation of the RICO settlement agreement, in which it agreed to provide greater notice of policy and procedure changes.

CMA is collecting data to provide DMHC with additional examples of difficulties and delays practices are experiencing when attempting to obtain the new Blue Cross fee schedule.

Please take a few minutes to complete this brief survey.

Contact: CMA's reimbursement help line, 888/401-5911 or gfonseca@cmanet.org.

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