The American Medical Association will enforce the Blue Cross and Blue Shield Association settlement of a national class action lawsuit as a signatory medical society to the agreement.
The settlement is for a nationwide physician class action lawsuit brought against the BCBS Association and more than 30 affiliated plans and subsidiaries.
The AMA joins 27 other participating medical societies that are able to provide direct assistance to physicians when a BCBS plan or subsidiary has failed to comply with the national BCBS settlement.
"The AMA believes that the transparency and fairness mandated by this settlement will allow physicians to redirect their limited resources from battling for fair payment to caring for patients," said AMA President Ronald M. Davis, MD. "The AMA stands ready to ensure physicians receive all the protections offered by the national BCBS settlement."
According to the AMA, the "provisions of the settlement resolve contentious business practices that have long frustrated physicians and jeopardized the delivery of high-quality patient care."
Key provisions address recognition of coding guidelines, prompt payment, medical necessity, physician credentialing and disclosure of fee schedules, claims procedures and payment policies.
Several provisions apply as of April 21, 2008, and will become enforceable as soon as any appeals filed in the next 30 days are resolved. A settlement map has also been provided, listing which BCBS plans and subsidiaries have settled, state-specific provisions of the agreement and the effective dates of the various provisions.