June 2020
We’re revising our Participating Hospital Agreement
With input from the hospital industry and the Michigan Health & Hospital Association, Blue Cross Blue Shield of Michigan is in the process of updating its model Participating Hospital Agreement. Due to current events, this course of action could be subject to change.
The new PHA model will modernize contractual language, define processes and augment future efforts to address affordability issues.
PHA revisions include:
- Eliminate Blue Cross interim payments for all hospitals.(See the third question on the frequently asked questions document, which we link to below.)
- Eliminate the annual settlement process.
- Streamline the appeals process.
- Update the contract administration process.
- Simplify Peer Group 5 administration.
- Eliminate Exhibit B and references to reimbursement for hospitals in Peer Group 1 through 4.
How do I learn more about the PHA changes?
Refer to the FAQ document for additional information or contact your contracting team.
- Mike Andreshak, director, 313-448-3905 or MAndreshak@bcbsm.com
- Lynda Cerutti, director, 269-321-7680 or LCerutti@bcbsm.com
- Fred Schaal, director, 810-720-8555 or FSchaal@bcbsm.com
- Kurt Prettenhofer, manager, 313-448-5815 or KPrettenhofer@bcbsm.com
- Lauren Rossi, manager, 313-448-6090 or LRossi2@bcbsm.com
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