The California Medical Association wants Cigna to rescind a recently announced policy the group said "effectively penalizes physicians for providing efficient, unscheduled care to Cigna enrollees."
Cigna's policy change will require the submission of medical records for all evaluation and management claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed, according to a June 27 California Medical Association news release. The change is set to go into effect Aug. 13.
The California Medical Association said Cigna's policy change will result in significant, unnecessary administrative burden and compliance cost to physician practices. It will also disincentivize physicians from providing unscheduled services and create duplicate requests, wasting healthcare dollars, the association said.
The group said the policy also lacks clarity on product types affected, is inconsistent with industry standards and CMS guidance and may violate California law.
The association said it believes a more collaborative approach to find ways to save money will be more effective in the long term.