January 6, 2009

Dear Business Partner:

Tufts Medical Center Provider Termination
Over the past year we have been in negotiations with the New England Quality Care Alliance (NEQCA), an organization of physicians, including approximately 100 primary care physicians (PCPs) and 340 specialists affiliated with Tufts Medical Center. We have been attempting to reach an agreement based on our Alternative Quality Contract. These contract terms are consistent with those we have offered other physicians, and would allow this group to achieve all of their financial goals while moving toward a system that rewards them for better patient outcomes.

With this in mind, we regret to inform you that NEQCA has terminated these physicians from our network. As of February 1, 2009, this subset of NEQCA physicians will no longer be a part of our participating HMO Blue^®, Blue Choice^® (POS), Blue Care^® Elect (PPO), and Managed Blue for Seniors^SM provider networks. These NEQCA physicians will no longer be part of our Indemnity provider networks, effective January 2010. Approximately 14,000 Blue Cross Blue Shield of Massachusetts HMO members will be affected by this termination. Blue Cross Blue Shield of Massachusetts Medicare Advantage members are not affected.

Please note that the Tufts Medical Center hospital and numerous Tufts physicians are not affected by this network termination.

View the list of affected NEQCA physicians and physician groups

Affected Member Support
Given your clients' and our shared concerns about the affordability of health coverage, we are disappointed that this subset of NEQCA doctors chose this course of action, especially with so little time before the end of the contract. We will work with your clients and their employees to ensure that affected members do not experience disruptions in care. We have provisions for members' continuity of care for those members who are:

• In their second or third trimester of pregnancy
• Undergoing active treatment for a chronic or acute medical condition
• Terminally ill

Members with a physician in this subset of NEQCA may have received, or soon will receive, a letter from their doctor stating that the member won't be able to see him or her for covered services after January 31, 2009. We are writing to accounts and members to let them know that we have established a dedicated toll-free phone number at 1-888-404-9846 to assist affected members in choosing a new participating provider. HMO members can also search for a new physician online by visiting Find a Doctor.

As we move forward, our most important consideration will always be to put our members' health first by ensuring that they have access to the care they need from our high-quality network of over 6,000 PCPs and 13,000 specialists.

If you have any questions, please contact your account executive.

Sincerely,

Tim O'Brien
Senior Vice President
Sales Division

* This list reflects the most accurate information available to Blue Cross Blue Shield of Massachusetts at the time it is published. New information may occasionally be posted in this document, so you may want to check back periodically to see if there are any changes relative to your providers.

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