Nonprofit Blues Plans Have Amassed Huge Surpluses: Report

In the last decade, nonprofit Blue Cross and Blue Shield (BCBS) plans have set aside billions of dollars in surplus, even as they raised rates for many customers, according to a widely publicized report issued by the nonprofit group Consumers Union. Nonprofit BCBS plans, including community-owned charitable plans and subscriber-owned mutual plans, held more than $32 billion in surplus at the end of 2008.

In researchers’ sampling of 10 nonprofit BCBS plans, seven held more than three times the amount of surplus that regulators consider to be the minimum amount needed for solvency protection. For example, BCBS of Arizona has surplus more than seven times the regulatory minimum as of the end of 2009. Health Care Service Corporation, a mutual insurer doing business as BCBS of Texas, Illinois, New Mexico and Oklahoma, has five times the regulatory minimum. Meanwhile, over the past three years both insurers continued to raise their rates.

The report calls on state insurance regulators to scrutinize surpluses when considering rate increases and set maximum limits for surpluses. 

BCBS Louisiana Billing Guidlines to Change February 2, 2010

bcbslaThe following announcement has been posted in RED on the BCBS of Louisiana provider billing guidelines, online at:  BCBS Louisiana’s Provider Manual.

Updated Billing Guidelines
Please note that new Anesthesia Billing Guidelines will be effective February 2, 2010. Providers will receive advanced notification of the new guidelines and this manual will be updated accordingly.     BCBS Louisiana Provider Manual 2009 Rev1:3, page 42 of 92

It appears that BCBS of Louisiana is prepared to release new billing requirements even before they have completed the contracting with the state’s anesthesia providers. This is a risky proposition since most providers are anxiously awaiting the new contract rates and the proposed provider (MD/CRNA) spit by BCBS of Louisiana. In a recent email from Stacy Musgrove, BCBS Network Development, he indicated that BCBS has pushed back the mailing date for new BCBS anesthesia provider contracts from Juy 1 to August 1.