On Tuesday, March 24, 2026, the Michigan State Medical Society (MSMS) led a contingent of 17 advocates to meet with Blue Cross Blue Shield of Michigan (BCBSM) regarding their new modifier 25 policy. The group was comprised of MSMS President Amit Ghose, MD, MSMS Immediate Past President Mark C. Komorowski, MD, MSMS CEO Tom M. George, MD, American Medical Association (AMA) President and past MSMS President, Bobby Mukkamala, MD, specialty society leaders representing allergy and asthma, dermatology, ophthalmology, otolaryngology, and orthopaedics, key AMA reimbursement policy staff, and leaders from Great Lakes Physician Organization (GLPO) and the Michigan Health & Hospital Association (MHA).
The message presented by the group was strong and provided evidence that the policy and their stated rationale is misguided. Sherry Smith, AMA Director of Physician Payment Policy, began with an overview of the information used in formulating the Resource Based Relative Value Scale (RBRVS), and an explanation of the RVS Update Committee (RUC) valuation process and how the use of modifier 25 does not result in duplication of payment. This was followed by examples from the physician representatives, GLPO, and MHA of the policy’s impact. They emphasized the need for reimbursement to support patient-centric care, impact on the viability of independent practices, and harm to patient access to care if the policy goes into effect. The medical community was well represented as all of the speakers articulately presented a true picture of the detrimental consequences should this policy not be rescinded.
The BCBSM team was led by James D. Grant, MD, MBA, Senior Vice President and Chief Medical Officer, Amy Milewski, MD, MBA, Vice President and Associate Chief Medical Officer, and Todd Van Tol, Executive Vice President of Health Care Value. They will be reviewing and evaluating the information provided and we expect to hear from them within a week or two. In the meantime, if this policy will adversely impact your practice, you can share your concerns with BCBSM through our grassroots action center.
MSMS expresses our gratitude to the many state and national specialty societies and individual physicians, leaders, and staff offering advocacy support and practice examples during these past several weeks. And special thanks to those who gave of their time and expertise to join us for the meeting: Amit Ghose, MD, Bobby Mukkamala, MD, Heather McComas, PharmD, Sherry Smith, MS, CPA, Mark Komorowski, MD, Shay Raleigh, MPH, Jennifer DeMore, MD, Angie Kemppainen, CAE, Ali Moiin, MD, Jason Jorkasky, FACHE, Brandon King, MD, Taha Meraj, MD, Maria Woodward, MD, and David Patterson, MD.
Questions can be directed to Dara Barrera at djbarrera@msms.org or Stacey Hettiger at shettiger@msms.org.