News & Press: Member Updates

Premera Blue Cross Fee Schedule — What You Can Do Now

Tuesday, October 2, 2018  

Dear Washington Doctors of Chiropractic:


First, we want to thank you for sharing the details of the Premera Blue Cross fee schedule letter you received this week. We have copies, and we will respond following a review with counsel.


Premera’s proposed reimbursement scheme appears to be an aggressive response to the recently enacted legislation governing chiropractic services. Their scheme manipulates the methodology CMS has adopted to determine reimbursement. Rather than using the appropriate CMS conversion factor, Premera has modified the formula to reduce reimbursement to an unprecedented level.


The WSCA scheduled a meeting with the Office of the Insurance Commissioner (OIC) later this month. The OIC regulates insurers in Washington; therefore, we will start with the regulatory agency to address this issue. Implementation of the new law does not begin until January 1, 2019, and the WSCA is working diligently to resolve these problems before then.


What YOU need to do NOW!


  • CALL YOUR LEGISLATORS and tell them how Premera Blue Cross has responded to the new law.
  • File complaints with the OIC!
  • Be sure to tell them that Premera will pay you LESS than before the legislation was passed.
  • Make an appointment with your legislators and SHOW them how your pay has decreased since 2003.


Although we want to make this as easy as possible, in instances like these, form letters are not very effective. We need it to be more personal, and so we’re asking doctors to write their own letters individually. Here are some key points you’ll want to raise in your letter:

  • Comment about how this is less than you were paid last year.
  • Note that this pay is less than it has been since 2003.
  • Let them know that this fee doesn’t cover the cost of delivering the service.

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