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Life Health > Health Insurance > Medicare Planning

Blue Shield Of California Not Lowering Doctor Fees

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NU Online News Service, Dec. 12, 11:55 a.m. – Blue Shield of California, San Francisco, says says it will continue to reimburse physicians on its standard fee schedule at 2001 rates next year and that it is not going to adopt the Medicare physician payment rate decrease of 5.4% announced by the Center for Medicare and Medicaid Services earlier this month.

Unless Congress intervenes, Medicare’s physician payment cut will be effective Jan. 1, 2002. The 5.4% reduction will be the fourth time in 10 years that physician payment levels were lowered across the board, the company notes. Like many health plan providers, Blue Shield uses the Medicare fee schedule to reimburse most physicians participating in its non-capitated plans.

“Our members will receive better care if we minimize physician network disruption, and keeping fees steady will encourage more doctors to stay with our network,” says Ken Wood, executive vice president and chief operating officer of Blue Shield. “Federal officials should look seriously at revising Medicare payment schedules to ensure that reimbursements to providers and health plans are adequate to cover the cost of care.”

Two bills were recently introduced in Congress (H.R. 3351 and S. 1707) that would limit the reduction in physician payments to less than 1% below current fees. Blue Shield of California says it will follow these guidelines if they are enacted.


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