North Carolina Medical Society - NCMS Bulletin

Volume 61 Issue 18 – April 23, 2010

Featured Stories

If You Were Out-of-Network with UHC in the Last 15 Years, That Could Mean Dollars for You

A lawsuit led by the American Medical Association (AMA) against UnitedHealth Group has yielded a settlement agreement and $350 million to help compensate physicians and patients for artificially low payments for out-of-network services provided over the past 15 years.

DOI Disapproves Latest BCBSNC Provider Contract Addendum

Last week, the North Carolina Department of Insurance disapproved a proposed addendum from Blue Cross and Blue Shield of North Carolina that was intended to bring all active provider agreements into alignment with new fair contracting laws passed by the General Assembly last year.

UPDATE: NC Department of Insurance Takes Up Aetna Mid-Level Issue

Responding to NCMS correspondence regarding Aetna’s proposed reimbursement cut for mid-level practitioners, the NCDOI has since indicated to the NCMS that they intend to handle the matter as a consumer services complaint. Currently DOI is awaiting a written response from Aetna, which is due next week.

Campaign to Avoid “Medicare Meltdown” Gains Momentum

More signatures are being added daily to a petition that will ask Congress for a permanent fix to the sustainable growth rate (SGR) to avoid a “Medicare Meltdown.” As of Thursday, nearly 47,000 names from across the country had been added to the petition.