Coming soon: BCBSM to contract with ambulatory infusion centers

Blue Cross Blue Shield of Michigan will contract with qualified ambulatory infusion centers under a newly modified Infusion Therapy Provider Class Plan this year.

AICs administer infusion therapy and select injections to patients in freestanding outpatient facilities. AICs will provide an additional location option for patients receiving infusion therapy.

Applications for enrollment are expected to be available in May 2013 for an Aug. 1, 2013, effective date.

The addition of ambulatory infusion centers means that:

• AICs will be designated as a unique provider type.
• We will formally contract with AICs.
• AICs will be identified in the provider directory on bcbsm.com and the Blue Cross and Blue Shield Association website.
• AICs will be reimbursed for the administration of infusion therapy and select injections as well as related medications.
  • AICs will be reimbursed for medications at the same rate as home infusion therapy providers.
  • Payment for administration of the drugs will be the same as under the physician office infusion therapy benefit.
• Participation for AICs is on a formal basis only, which means there is no “per-claim” participation. BCBSM will not pay for infusion therapy services provided by nonparticipating AICs. 
• All participating AICs will be considered to be in-network for PPO members, and out-of-network sanctions will be waived.

Home infusion therapy providers that have infusion suites will need to register as AICs to be reimbursed for services provided in the infusion suites. You may continue to provide home infusion therapy under your current HIT agreement.

Key eligibility requirements
Ambulatory infusion centers must meet BCBSM’s quality standards and be fully accredited in infusion therapy by a national accreditation organization such as The Joint Commission, The Accreditation Commission for Health Care or the Community Health Accreditation Program. AIC staff must be trained in infusion therapy and include, at a minimum, a registered pharmacist, a registered nurse and a medical director, all licensed by the state of Michigan.

If you are interested in joining this network, enrollment materials will be available electronically on bcbsm.com in May. Look for more information in future issues of The Record.