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