This week, Anthem Blue Cross Blue Shield of Connecticut sent letters to Connecticut physician specialists informing them that they are being terminated from the Medicare Advantage Select Plan provider panel. The termination would take effect January 1, 2020. It does not affect the physician participation status with the other Anthem Medicare Advantage plans or commercial insurance products; and it does not impact primary care physicians.
CSMS has reached out to Anthem (click here to read the letter/email that was sent) and they have told us that all terminated physicians and providers have appeal rights for the termination, which are outlined in the letter. CSMS is very concerned regarding this action and we will be focusing in on the cause and possible remedy to help our the impacted physicians.
- CSMS has developed a tool to help guide you through the appeal process – click here to access
- CSMS has created a guide to help you communicate the termination to your patients – click here to access
- CSMS staff is looking at the legal and regulatory remedies
- CSMS has reached out to other anthem states to determine if this is a national issue
- CSMS is encouraging physicians to appeal if they believe they were inappropriately terminated from the network.
More to come on this and we are engaging our lobbying team and grass roots efforts. Please reach out to us if you have any questions or concerns – we are here to help! Contact us today: MKatz@csms.org or LGakos@csms.org.