URGENT Message Regarding Premera's
Fee Schedule Change Notice
On Monday, August 1, 2005,
the WSCA learned through its members that Premera Blue Cross has decreased
the payment for chiropractic services. WSCA has contacted Premera
Blue Cross to voice concern about two things. First, the lack of notice
to WSCA regarding this change in a timely manner; and second, lack
of requested input from WSCA in an effort to avoid having to decrease
the fee schedule.
Premera Blue Cross has
informed WSCA that they are implementing the decrease because they
feel they need to be more competitive and they report they are the
highest payer for chiropractic services. Additionally, Premera reports
they are decreasing the fees so they can have an open chiropractic
panel.
The issue related to an
open chiropractic panel is irrelevant since the panel has been open
under Alternare, and will also be open under American Wholehealth
Networks.
While federal anti-trust
laws limit the method that an association can use to challenge such
issues as fee schedules, we are obtaining legal advice on how we can
protect appropriate payments for chiropractic services.
It is important to know
that even though American Wholehealth has recently taking over management
of the chiropractic panel for Premera, that the fee schedule remains
the responsibility of Premera Blue Cross. The letter you received
from Premera and American Wholehealth Networks on Monday, August 1,
2005 directs you to contact American Wholehealth Networks with your
concerns. However, the WSCA recommends you also contact Premera Blue
Cross. You may contact the provider relations division of Premera
Blue Cross or you may contact Deborah Drinkwater at 425-918-3670.
It is critical
that chiropractors do not violate anti-trust laws! Please make all
decisions independently, and make individual complaints directly to
Premera and/or American Wholehealth Networks.
If you're not an
active WSCA member, how are you helping WSCA to help you??
Sincerely,
Lori Bielinski, LMP, Executive
Director