Blue Cross Blue Shield of Michigan is apologizing for a significant error in its benefits plan documents for 2018.
The error related to mental health and substance abuse treatment. Benefits summaries for some plans said they required prior authorization for mental health or substance abuse outpatient treatment.
That sent some patients--and their doctors--into a panic. A requirement for prior authorization could mean that some patients would not be able to continue their treatments, or might be required to change providers.
Lou Feurino is a psychiatrist who participates with Blue Cross Blue Shield. He says the unexpected plan changes were a major setback for some patients.
“I think it does put patients off. It takes an arcane system and makes it more confusing," Feurino said. "But even more importantly, it creates uncertainty and anxiety.”
Prior authorization was not required for comparable outpatient visits for medical and surgical treatment, raising questions about parity among providers.
When Michigan Radio contacted Blue Cross Blue Shield, the company issued the following statement:
Blue Cross Blue Shield of Michigan does not require prior authorization on outpatient mental health or substance abuse treatment for its individual PPO plans.
Our benefits at a glance and certificate correctly show outpatient mental health and substance abuse do not require pre-authorization. We are in the process of correcting the summary of benefit and coverage document so it says the same. We apologize for any confusion this has caused.
The document errors were corrected by end of the day Friday, Nov. 10.