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Blue Cross Blue Shield Changes

Thursday, September 19, 2013 12:25 PM | Anonymous

In response to the Blue Cross Blue Shield "site of service differential," and specifically, the June 1, 2013 notice of further reduction in reimbursement for endoscopic procedures performed in hospitals, we took the following actions:

  1. Retained the counsel of attorney Michael Blau, Esq from Foley and Lardner, LLP.
  2. Solicited the input of our national GI societies.
  3. Filed a formal complaint (93A Demand for Relief August 27,2013) with the Massachusetts Commissioner of Insurance, the Massachusetts Attorney General, and the State Bureau of Consumer Affairs.

The MGA believes this policy is unfair and unsafe for patients and consumers by limiting necessary hospital services and intruding inappropriately on the patient-provider relationship. We believe it violates Massachusetts law by flouting anti-kickback statutes, and restricting treatment for patients without adequate education of consumers and without approval from the appropriate state officials.

We await a response and will keep you informed.

The MGA Board

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