AMA Committed To Enforcement Of BCBS Settlement

Main Category: Public Health
Article Date: 23 Apr 2008 - 4:00 PDT

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The American Medical Association (AMA) announced that it will begin enforcement of the national Blue Cross and Blue Shield (BCBS) settlement as a signatory medical society to the agreement. The AMA joins 27 other participating medical societies that are able to provide direct assistance to physicians when a BCBS plan or subsidiary has failed to comply with the national BCBS settlement.

The AMA's participation in enforcement of the BCBS settlement was initiated yesterday when a Miami federal court finalized the settlement of a nationwide physician class action lawsuit brought against Blue Cross and Blue Shield Association and more than 30 affiliated plans and subsidiaries.

"The AMA believes that the transparency and fairness mandated by this settlement will allow physicians to redirect their limited resources from battling for fair payment to caring for patients," said AMA President Ronald M. Davis, M.D. "The AMA stands ready to ensure physicians receive all the protections offered by the national BCBS settlement."

The provisions of the settlement resolve contentious business practices that have long frustrated physicians and jeopardized the delivery of high-quality patient care. Key provisions address recognition of coding guidelines, prompt payment, medical necessity, physician credentialing, as well as disclosure of fee schedules, claims procedures and payment policies.

Several provisions contained in the BCBS settlement apply as of April 21, 2008, and will become enforceable as soon as any appeals filed in the next 30 days are resolved. To assist physicians in finding accurate information about the settlement, the AMA offers an interactive on-line map that lists which BCBS plans and subsidiaries have settled, state-specific provisions of the agreement, and the effective dates of the various provisions.

Physicians can find additional information regarding the BCBS settlement, or inquire about assistance with an enforcement issue, by visiting the AMA website at: http://www.ama-assn.org/go/settlements.

American Medical Association

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