Anthem Rescinds Termination Policy
Providers in the network do not need to overhaul their DMEPOS accreditation.
- By David Kopf
- Dec 01, 2011
Anthem Blue Cross Blue Shield of Georgia has notified its network of DME/HME providers in a Nov. 11 letter that it will not remove them from its network after March 1, 2012, eliciting a collective sigh of relief from the Peach state.
On May 31, Anthem had sent its DME providers a contract amendment, which included new criteria for network participation, including new accreditation requirements beyond standard Medicare DME accreditation. Anthem said all DME providers had to comply with the new accreditation requirement by March 1, 2012 in order to continue participation in its networks.
"Most participating providers have responded and provided documentation demonstrating they currently meet these standards," wrote L. Kathryn Norman, Anthem's vice president of Ancillary Provider Engagement and Contracting, in the Nov. 11 letter. "We have also heard from other DME providers that more time is needed before being able to meet these criteria and asking we consider expanding the number of accrediting bodies recognized.
"To that end, in the spirit of partnership, we will not terminate currently contracted providers which have not met these standards by March 1, 2012," she stated.
Needless to say, the earlier announcement not only alarmed providers, but Medicare accreditation organizations, as well. The Compliance Team (TCT), one of CMS's “deemed” accreditation organizations that was excluded by Anthem, had voiced its concerns, along with more than 150 of its accredited DMEPOS providers based in Georgia.
Given that Anthem Blue Cross Blue Shield of Georgia is a wholly owned subsidiary of Wellpoint Inc., which works with nearly 2,000 TCT-accredited provider across 14 states, TCT President Sandra Canally, RN said she was confident that Wellpoint's Anthem subsidiaries "will come to the same conclusion as CMS, and recognize the enhanced patient care values that The Compliance Team’s accreditation programs."
"The realization that Anthem of Georgia has rescinded its 'termination' policy and is moving to re-open its 'evaluation of the numerous accrediting bodies' is seen as welcomed news to the thousands of providers accredited by TCT throughout the United States and Puerto Rico," Canally added.
David Kopf is the Editor of HME Business.