Action Needed: BCBS of Alabama Proposed Policy 566 is Harmful for Good Pain Management
Blue Cross Blue Shield of Alabama, which controls approximately 85-95% of the commercial insurance market in Alabama, has drafted a policy (policy 566) to go into effect March 16, 2015 categorizing quantitative urine drug testing as investigational as it relates to the treatment of chronic pain only. The impact on practice will occur when clinicians perform a quantitative urine test to investigate the presence or absence of prescribed and non-prescribed medications, and normally use a procedure code for billing. If this procedure code is no longer accepted and reimbursed, it will place an added financial burden on patients and many healthcare providers would opt out of performing this useful test when managing patients on opioid analgesics.
The draft policy, which is up for public comment, can be found here:
- Please submit comments ASAP to BCBS to let them know this will have detrimental effects on people with chronic pain as well as the providers who are caring for them. BCBS of AL is trying to reclassify quantitative urine drug tests as an investigational procedure, and BCBS of AL does not pay or reimburse for investigative procedures.
Submit comments by March 13 to: Patrick Ryse, MD, Medical Director, BCBSAL, 450 Riverchase Pkwy E Birmingham, AL 35244.
- Sign a petition by clicking here.
At a minimum, this means that pain management providers will not have the qualitative tools they require to properly treat and manage pain, and the majority of patients they care for will be unable to pay out of pocket for these tests.