DETROIT, April 3, 2020 – As a part of Blue Cross Blue Shield of Michigan’s ongoing efforts to help the health care community respond to the coronavirus pandemic, BCBSM is accelerating payments to Michigan-based physician organizations and practices to support their efforts for treating patients with COVID-19. Additionally, BCBSM is relaxing some of its administrative requirements to allow Michigan’s physician organizations and health systems to spend more time treating patients and hasten their diagnoses and treatment. The accelerated funding is available to the more than 40 physician organizations that are a part of Blue Cross’ Physician Group Incentive Program (PGIP), including more than 20,000 primary care and specialist physicians throughout Michigan. Partnerships built through this 15-year-old program improve quality, collect data and share information and are now being used to help providers adapt to the global pandemic. The PGIP incentive program has a set amount of funding for each year that physician organizations can earn through performance. Blue Cross is advancing funds that would have been spent later in 2020 through this program to give PGIP-affiliated physician organizations the immediate financial means to purchase equipment needed to safely test for COVID-19 and treat patients successfully, and to pay physicians for the care they provide through telehealth visits. “Blue Cross supports those on the front lines of managing this crisis and saving people’s lives,” said Blue Cross Blue Shield of Michigan President and CEO, Daniel J. Loepp. “There are certain things doctors need in an emergency – including more resources and more time to spend with patients. Blue Cross is trying to help.” “Our provider partners have told us they lack specialized equipment needed to test for COVID-19 and engage with their patients,” said Todd Van Tol, senior vice president for Health Care Value at BCBSM. “Physician offices need to be well-resourced and available, through technology, so our members can consult with their doctors from home.” Blue Cross Streamlines Administrative Requirements There are essential requirements on health care providers that serve to protect the integrity of billings and payments, prevent waste, and ensure that patients are protected throughout the care process. BCBSM has identified several of these administrative requirements to temporarily relax during the COVID-19 crisis to help providers assign more resources to deliver care where it’s needed most. BCBSM announced the following temporary changes for Michigan-based providers:
- No prior authorization for diagnostic testing of patients for COVID-19.
- Suspending clinical review requirements for CT scans of the chest when used to assess COVID-19.
- Suspending clinical review requirements at all acute care hospitals for all diagnoses for all medical admissions, including COVID-19 and other admissions.
- Suspending clinical review requirements for the first three days at all skilled nursing facilities when patients are transferred from an acute care hospital.
- Extending the effective dates for approved prior authorizations.
“These actions speed care to patients and prepare doctors and hospitals to face the pandemic,” Van Tol said. “Blue Cross has deep roots in Michigan and strong relationships with providers of care. We are mobilizing our statewide connections and leveraging our network to help providers address a major public health crisis.” Blue Cross leaders are also facilitating weekly calls between physicians in the PGIP program and experts, including state authorities and testing laboratories, to keep Michigan’s physicians up-to-date and able to access the latest testing criteria. More information on the company’s response to the COVID-19 pandemic is available on the company’s blog – www.mibluesperspectives.com. Blue Cross Blue Shield of Michigan, a nonprofit mutual insurance company, is an independent licensee of the Blue Cross and Blue Shield Association. BCBSM provides health benefits to more than 4.7 million members residing in Michigan in addition to employees of Michigan-headquartered companies residing outside the state. The company has been committed to delivering affordable health care products through a broad variety of plans for businesses, individuals and seniors for 80 years. Beyond health care coverage, BCBSM supports impactful community initiatives and provides leadership in improving health care. For more information, visit bcbsm.com and MiBluesPerspectives.com.