Hudgens orders Blue Cross to rescind physician contracts

State Insurance Commissioner Ralph Hudgens ordered Blue Cross Blue Shield of Georgia to rescind changes it recently made to its contracts with physicians.

Hudgens said he ordered the insurer to reverse the changes to its current contracts after receiving “numerous complaints” from physicians around the state about the “heavy handed approach taken by Blue Cross regarding their contract changes.“

“I want doctors spending time caring for their patients, not being stonewalled by an insurance company,” Hudgens said.

Hudgens took the regulatory action less than a week before election day, when he is running for another term against Democratic challenger Liz Johnson.

A Blue Cross spokesman said the insurance carrier had already made a voluntary offer to rescind the contract changes.

“We have been working for several weeks in good faith with the Department of Insurance and the commissioner on this issue,” said Tony Felts.

“Recognizing the complexity of the matter, and to avoid creating confusion for the physicians in our network, we voluntarily offered to rescind these contract amendments while we continue the dialogue,” Felts said. “We look forward to continuing the discussions to reach a solution that benefits everyone involved.”

Blue Cross Blue Shield is the largest insurer in Georgia and is also the administrator of the State Health Benefits Plan, a $3 billion health insurance plan that covers state employees, public school teachers, dependents and retirees.

The State Health Benefits Plan contract is handled by the Department of Community Health, not the insurance commissioner.

Hudgens said his order “resets the process while at the same time preserving the existing physician agreements without the amendments. Georgia consumers will have continuous access to their Blue Cross contracted doctors and will not be impacted by this action.”

He said the complaints he received from doctors included:

  • The sample fee schedule did not accurately reflect the actual reimbursement rates.
  • Doctors indicated that when calling Blue Cross for clarification, answers were not responsive.
  • Doctors reported that when they contacted provider representatives at Blue Cross they were told several practices received the amendment, but should not have. Other providers reported being told the opposite.

© 2014 by The Georgia Report

Tags: Blue Cross Blue Shield , physician contracts , Ralph Hudgens