Blue Cross and Blue Shield of Texas has agreed to stop using its risk-adjusted cost index to rate physicians as more or less affordable in providing medical treatments to patients, following an order from Texas Attorney General Gregory Abbott. The insurer has also agreed not to terminate—or threaten to terminate—physicians for making referrals outside of the Blue Cross and Blue Shield network.
According to the order, the Consumer Protection & Public Health Division of the attorney general’s office began an investigation in January 2008 into Blue Cross and Blue Shield of Texas’ use of its risk-adjusted cost index methodology to conduct and publish “affordability” quality assessments of healthcare providers, as well as the company’s communications that threatened to terminate those physicians who referred patients for treatment outside the network.
Josie Williams, a physician who serves as president of the Texas Medical Association, called the order a “huge victory for patients” because, she said, patients and their doctors should make decisions regarding patient care.
“After listening to the concerns expressed by the attorney general’s office and other constituents, Blue Cross and Blue Shield of Texas voluntarily modified certain business practices related to (the) provision of consumer information several months ago,” Margaret Jarvis, a company spokeswoman, said in a written statement.
