Anthem Blue Cross recently issued a systemwide notice to over 70,000 physicians with an amendment to its Prudent Buyer Plan Participating Physician Agreement that will require contracted physicians in California to maintain privileges with at least one participating ambulatory surgery center (ASC). This policy goes into effect September 1, 2023.
The changes, reflected in the addition of language to the Prudent Buyer Agreement, indicate that unless Anthem agrees in advance in writing, physicians must maintain privileges at a licensed, in-network ASC. Currently, Anthem only requires physicians to maintain hospital privileges at an in-network hospital.
Anthem has advised the California Medical Association (CMA) that this requirement is intended to ensure that all participating physicians who perform surgical procedures appropriate for an ASC site-of-service have privileges at an in-network ASC facility. Read more.
