MDs Protest New BCBST Policy Intended to Save Clients Money

BlueCross BlueShield of Tennessee, Inc. (BCBST) has found itself in the news recently but probably not for reasons the health plan might like: The insurer has received tremendous pushback from physicians on its decision to implement a policy requiring them to get provider-administered therapies from specialty pharmacies. But the health plan maintains that it has implemented the program in response to client demands and that the new policy will save money for its self-funded employers that opt into the program.

Providers traditionally have acquired therapies they administer through a practice known as buy and bill, by which they will purchase a drug from a wholesaler or distributor, keep it in their office and administer it to patients as needed, submitting a claim to the payer afterwards. Through this approach, providers can make a profit by marking up the drug.

Angela Maas

Angela has an extensive background of editing, reporting and writing for trade and consumer publications. She has written Radar on Specialty Pharmacy (formerly called Specialty Pharmacy News) since she joined AIS Health in 2005 and has broad knowledge of the various issues at play within the space. Before joining AIS Health, she was managing editor at Employee Benefit News and Employee Benefit News Canada and managing editor at HemAware (a hemophilia publication), Lupus Living and Momentum (a multiple sclerosis publication). She has a B.A. in English and an M.A. in British literature from Arizona State University.

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