Doctors Protest Blue Cross of California’s Planned Payment Cuts
Blue Cross of California is set to adopt new physician payment rates next month, cutting reimbursements for about half of covered services and procedures, the Los Angeles Times reports.
Shannon Troughton -- a spokesperson for Blue Cross, California's largest for-profit health insurer -- said that the number of services for which payments are being increased is about the same as the number of planned cuts. She said the new payment rates were based on health care cost and reimbursement data from Medicare and other payers.
However, physicians have long criticized Medicare payments as inadequate, arguing that the federal program often does not cover the cost of services.
Similarly, some physicians say that Blue Cross' new payment rates will fall below the cost of delivering care, with some doctors saying the new pay structure will drop reimbursements for some services by one-third or half.
As a result, some physicians have told Blue Cross they will end their contracts with the insurer, while other doctors have informed patients that they will have to pay the difference between Blue Cross' reimbursements and the physicians' charges.
The issue is expected to come up for discussion at a Department of Managed Health Care hearing about Blue Cross practices on Aug. 7 (Girion, Los Angeles Times, 7/23).