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Managed Care Update

Changes in Magellan and Blue Cross Blue Shield of Massachusetts

Starting January 1, 2006, Blue Cross Blue Shield of Massachusetts (BCBSMA) will offer a new HMO behavioral health network to certain members of its "local" managed care plans: HMO Blue, Blue Choice Plan 1 and 2, Access Blue, and Network Blue. Magellan will continue to manage the care provided to members of BCBSMA’s New England managed care plans: HMO Blue New England, Blue ChoiceÒNew England, and Network Blue New England.
While you may currently hold Agreement(s) with BCBSMA for indemnity, PPO, or certain other HMO plans, you’ll need to complete the enclosed Agreement by April 28, 2005 to ensure continuity of care for your patients.
BCBSMA also announced that the HMO fee schedule for the new BCBSMA HMO network will take effect on January 1, 2006 and represent an aggregate 6 percent increase over current fees.

Be sure to watch your mail for the contract mailing from BCBSMA and return the enclosed Agreements and supporting documents by April 28, 2005. Until the new network takes effect on January 1, 2006, you can continue to conduct business as usual for your BCBSMA patients. Later this year, BCBSMA will send you information about how to submit claims and receive authorization for services for members in the new network.

PacifiCare and Harvard Pilgrim Health Care

PacifiCare, which now manages behavioral health for Harvard Pilgrim Health Care, may still be credentialing new providers for their network. For more information contact David Nefussy, Provider Relations at 781-348-5605 or
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