In what may be indicative of a new trend by payers, BlueCross BlueShield of Tennessee (BCBS-TN) has cut payment for laboratory services to 52 percent of Medicare rates, effective Jan. 1, 2014. In a letter sent to providers on Nov. 6, 2013, BCBS-TN said its rates for physician labs are higher than national and local market levels. As a result, the payer says all codes classified as lab services will be reimbursed at 52 percent of Medicare. In 2013, BlueCross BlueShield of Mississippi reduced reimbursement up to 25 percent for pathology and radiology procedures, ostensibly in response to Obamacare. According to the Pathology Blawg (www.pathologyblawg.com), a BCBS-TN provider told a group of clinicians that this massive reimbursement cut is simply an extension of BCBS-TN’s Medicaid contract with Quest Diagnostics and will give independent labs a chance to compete with Quest for BCBS-TN’s business. The Tennessee Medical Association (TMA), in a Dec. 17 letter to BCBS-TN, requested that BCBS-TN rescind the contract amendment, saying “this unilateral decrease in agreed-upon contracted rates in mid-contract is untenable for Tennessee physicians and the patients they serve.” According to the letter, there is no “congruence of message” from BCBS-TN as to whether the cuts apply…
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