Features

Michael Tulloss – Capital Blue Cross

Priceless satisfaction from counseling nonprofit Capital Blue Cross

Michael Tulloss has spent the bulk of his legal life in insurance and healthcare administration, having counseled for-profit and nonprofit entities, and prefers the latter.

“Working for a nonprofit connects you more closely with the customers you serve instead of feeling like you only answer to stockholders,” Tulloss tells Vanguard. “That is such a huge factor to me personally.”

Michael Tulloss | Associate General Counsel | Capital Blue Cross

Michael Tulloss | Associate General Counsel | Capital Blue Cross

He says his current role as associate general counsel of Pennsylvania-based Capital Blue Cross has been the most satisfying, in large part because the work he does for the nonprofit insurer is “societally impactful” to Capital’s nearly 1 million members.

Once a vaccine became available, for instance, Capital Blue Cross, along with a Pennsylvania-based pharmacy chain, co-hosted vaccine clinics across its 21-county service region in Pennsylvania, including in medically underserved communities. The clinics—staffed in part by Capital employees like Tulloss who volunteered their time—provided the vaccine to many who might not otherwise have received it, including senior citizens.

Pandemic and Pennie

The pandemic coincided with the launch of Pennsylvania’s state-based health insurance marketplace, created pursuant to the federal Patient Protection and Affordable Care Act, more commonly known as Obamacare.

For that, Capital’s legal team worked with Pennsylvania Gov. Tom Wolf’s administration to ensure the firm’s participation on the commonwealth’s insurance marketplace, referred to as Pennie, which was rolled out in September 2020.

“Programs like this really can make a difference,” Tulloss told Vanguard.

Michael Tulloss | Associate General Counsel | Capital Blue Cross

Then there was last year’s federal Consolidated Appropriations Act, a $2.3 trillion spending bill that combined $900 billion in stimulus relief with $1.4 trillion in omnibus spending and touched practically every economic sector.

On the healthcare front, its effects are many and mostly welcomed by Tulloss. This year, a ban takes effect on what’s known as surprise medical billing, in which patients sometimes face unexpected charges when using emergency care from an out-of-network hospital, or when their in-network hospital uses an out-of-network specialist. With the change mandated by CAA, out-of-network providers must negotiate with insurers to be paid rather than billing insured patients directly, which protects the patient.

“This is so huge, and the insurance industry is so excited about it,” Tulloss says. “It really does protect consumers from unexpected charges and keep their costs down, which is one of the things Capital prides itself on doing.”

Also in CAA is mental health parity reporting, which requires health plan disclosure of comparative analyses that demonstrate parity between the plan’s mental health and substance use disorder benefits and its medical and surgical benefits. Tulloss says many in the industry previously did not ensure parity between these two benefit types, and with this now being law, consumers benefit.

Michael Tulloss | Associate General Counsel | Capital Blue Cross

The pandemic also led to streamlining and efficiencies in day-to-day work for Tulloss and his colleagues, as most of the Capital Blue Cross crew shifted to a remote work environment.

“We’ve all learned we don’t need as much paper as before,” Tulloss says. “That’s a side effect for the world. We’ve cut down fewer trees because we’ve stopped printing so much. But we also found more efficient ways to serve our members, including expanding coverage for telehealth services so we could help members get the care they needed even when they found it challenging to see a healthcare provider in person.”

True Blue

In today’s environment, pharmacy services might be the most challenging healthcare issue, Tulloss explains. It’s all part of the very detail-intense process that Tulloss has seemed to relish since earning his law degree at the University of Memphis in 1983. Since wrapping up a five-year run as an associate with the Tennessee firm of Luther, Anderson, in 1990, he’s held a string of in-house roles with insurance firms and healthcare administrators. 

He began a 14-year-stretch as associate general counsel of BlueCross BlueShield of Tennessee in 1999. He left Tennessee for a similar role at Memorial Hermann Health System in Houston, and in 2016 moved to Pennsylvania to be senior counsel at Capital Blue Cross. He assumed his current role in 2019, and he now oversees two other lawyers and a paralegal with primary legal oversight of Medicare Advantage, provider contracting, pharmacy services and managed care.  

Michael Tulloss | Associate General Counsel | Capital Blue Cross

And when Tulloss isn’t managing people, he just might be managing their best friends. A dog lover since childhood, in recent years Tulloss has been raising and showcasing Labrador retrievers bred by a friend. He co-owns four, and enters a male, Chase, and a female, Diana, into shows. Those pups, Tulloss says, embody the breed standard, whose attributes include strong back legs, an otter tail, lush coat, rounded head, strong chest and compassionate eyes. 

Time for such hobbies is limited, however. 

“I enjoy knowing that what we’re doing is going to have a positive impact on our members because when it comes down to it, that’s what is most important,” he says. “That’s why people love working for Capital Blue Cross.” 

View this feature in the Vanguard Spring III 2022 Edition here.

Published on: April 5, 2022

regions:

categories:

Showcase your feature on your website with a custom “As Featured in Vanguard” badge that links directly to your article!

Copy and paste this script into your page coding (ideally right before the closing tag) where you want to display our review banner.

Testimonials

The piece highlighting my company, Bob Baker Enterprises, Inc., came out fabulous. Our company is in the new and used car sales and service industry. Everyone was great to work with and extremely professional. They produced a high-quality product and have provided expert assistance and guidance post-production of the article.
– Wade Poulson, General Counsel, Bob Baker Enterprises Inc.
As promised in advance, my feature in Vanguard has increased my visibility within the profession and prompted more than a few people I have not communicated with recently to reconnect. One of the Italian law firms I have used in the past is now in the process of interviewing me for an article on their website and tweeting out the feature story. Activity and the number of people connecting with me on LinkedIn has soared, which is great. The Vanguard writers and editorial staff were great to work with—highly professional and made the effort to make the experience both fun and rewarding (they were also respectful of the time pressures and demands all lawyers face). I was very pleased with the experience and the final outcome. Needless to say, I have been very pleased. All in all working with Vanguard has been a very positive experience which generated good publicity for both Shawcor and myself. My sincere thanks.
– Tim Hutzul, General Counsel, ShawCor Ltd.
It was a great honor to be featured in Vanguard Law. Working with every member of the team, from the initial interview with Erin Clark, through production with Victor Martins, writing the article with Taryn Plumb and creating the final content with Dave Gushee, was a true pleasure. Everyone was very professional, enthusiastic and supportive, and their creative approach and positive attitude clearly came through in the final product.
– Kevin C. Rakowski, Senior Vice President, Deputy General Counsel, Compliance with Radian Group Inc.
I was honored to be the subject of an article. I enjoy reading Vanguard articles and seeing how other attorneys got to their positions and see their jobs. It's also interesting to see how different law firms partner with the subjects of the articles.
– Henry Marquard, in-house counsel, Stanley Consultants Inc.

LATEST EDITION

Fall II 2023

READ NOW

GET VANGUARD IN YOUR INBOX.

  • * We’ll never share your email or info with anyone.
  • This field is for validation purposes and should be left unchanged.