In June, the California Medical Association and hundreds of politically active California physicians forced Blue Cross to postpone its planned June 1 fee schedule changes until Aug. 6, because the company did not provide 45 days' notice. Due to the hail of phone calls doctors directed at the California Department of Managed Health Care, which oversees Blue Cross, the insurer did finally inform physicians of the upcoming schedule changes.

CMA members' calls "certainly" influenced the DMHC's actions, says Lynn Randolf, a spokeswoman for the agency. "[The CMA] brought the issue to us in mid-May, and we began talking to them and negotiating with Blue Cross." In all, almost 250 people called the DMHC to urge it to act against the insurer.

Blue Cross' failure to provide doctors with its fee schedule changes 45 days before its June 1 implementation is a violation of California's unfair payment practices law. Doctors need to know about reimbursement changes to plan their finances, but by May 31, the DMHC had not yet dealt with Blue Cross.

In order to kick-start the department, the CMA issued an immediate request for action through the county medical organizations. The Los Angeles County Medical Association sent a May 31 e-mail alert to district officers and board members, asking for their calls and e-mails.

The next day, CMA CEO Joe Dunn told the county medical associations in an e-mail message that the grassroots effort was effective. "We learned that the DMHC is continuing its investigation and is moving forth with an investigative subpoena to Blue Cross," Dunn said.
Randolf attributes the DMHC's delay in postponing Blue Cross' fee schedule changes to waiting for evidence from CMA and elsewhere that the insurer had failed to notify physicians.