ACS LITIGATION AND LEGISLATION FORCED BLUE CROSS BLUE SHIELDTO OPEN ITS PARTICIPATING AND PPO NETWORKS TO CHIROPRACTOR IN 2004 AFTER NEGOTIATIONS FAILED

ACS litigation and legislation forced Blue Cross Blue Shield to open its Participating and PPO networks to chiropractors in 2004 after negotiations completely failed to solve the problem.

The Arizona Chiropractic Society joined a federal lawsuit against Blue Cross Blue Shield in 2003. ACS sued BCBS for "limiting access of qualified chiropractic providers to enroll or contract under BCBS’ plans which provide preferential treatment for enrolled or contracted providers." The most glaring discrimination had been BCBS’ closure of the Participating Physician network to any new chiropractors which had caused huge problems in offices, most notably all payments were sent to patients even if assignment of benefits’ forms were signed. This lawsuit increased the pressure on BCBS.

From 1998 to 2003, ACS ran legislation every year to force BCBS to accept assignment of benefits, thus bypassing the need for membership in the Participating Physician Network. In the 2004 legislative session, Senator Mark Anderson, ACS Legislator of the Year, introduced SB 1177 on behalf of ACS. Click here to read the full text of SB 1177 along with details about its progress through the Legislature in 2004 from the Legislature's website.

The bill was scheduled to be heard in the Senate Health Committee on 2/26/04. Just before the hearing, a deal was struck between ACS, Senate Health Committee Chair Carolyn Allen and BCBS. The deal was that if BCBS would open up its Participating Network to ALL Arizona chiropractors, then ACS would drop its effort to pursue legislation and Sen. Allen would not hear SB 1177 in her committee as had been scheduled.

BCBS agreed and its lobbyist wrote a letter dated 3/08/04 stating: "This confirms Blue Cross Blue Shield of Arizona is about to perform a complete analysis of the chiropractic network." The letter was signed by Charles Bassett, Government Relations Director, BCBS of AZ. Finally the war was won! Click here to read a copy of the actual letter by Mr. Bassett.

Therefore, as a result of the lawsuit and legislative pressure, on October 8, 2004 BCBS opened its participating network to ALL Arizona chiropractors. Once a contract with the chiropractor was signed, then BCBS began to send payments directly to the doctor.

ACS and AAC had tried negotiations with BCBS on this matter for many, many years and they had always failed. In 2003, Dr. Immerman spoke directly with the President of BCBS of Arizona who he had known and worked with for fifteen years. The BCBS President adamantly refused to voluntarily open the network since this would allegedly increase chiropractic utilization, a negative outcome according to BCBS.  There is no question that it took a viable threat of a new law to force BCBS to open its network, along with a federal lawsuit.

The AAC repeatedly claims that a few meetings in 2003 and 2004 with BCBS were the cause of BCBS caving in and deciding to open its networks to chiropractors. This is simply false. It took the threat of impending and viable ACS legislation together with an underlying ACS federal court lawsuit to change BCBS policy. It is naïve, ignorant and/or disingenuous to state otherwise. This repeated attempt to rewrite history solely to justify the existence of the AAC must stop once and for all.