We’ll grant board certification exceptions for certain PCMH providers

Blue Cross Blue Shield of Michigan will continue to verify board certification statuses of practitioners in our Blue Cross and Blue Care Network managed care networks.

Effective Jan. 1, 2019, Blue Cross will annually review the board certification status of family medicine, internal medicine and pediatric practitioners. If their board certification status has lapsed and they are a designated Patient-Centered Medical Home physician, we’ll grant an exception and allow the practitioner to remain in our Blue Cross and BCN managed care networks.

This exception doesn’t apply to new practitioner enrollments. Blue Cross and BCN will continue to require all practitioners to have board certification upon initial enrollment for affiliation with us.

Non-board-certified family and internal medicine and pediatric practitioners who don’t have PCMH designation will be required to complete their applicable specialty’s Maintenance of Certification requirements within a two-year time frame. Failure to meet these requirements will result in termination from our managed care networks.