Hamm approves Blue Cross Blue Shield provider contract language
Posted on 1/26/2009
BISMARCK, N.D.-The North Dakota Insurance Department today approved a new Blue Cross Blue Shield of North Dakota (BCBS) provider contract, ending months of negotiation. The previous contract allowed BCBS to change provider payments at any time.
BCBS' 14.8 percent premium rate request submitted on May 6, 2008 for individual policies was disapproved by the Department in July. At the time of the disapproval, Insurance Commissioner Adam Hamm said part of the reason for the denial was the language in the contracts BCBS has with health care providers. The contract allowed BCBS to unilaterally reduce payments to health care providers.
BCBS appealed the denial, and an administrative hearing was held Nov. 24-26, 2008. Both sides are currently preparing post-hearing briefs, which will be submitted to the administrative law judge. She will issue a recommended decision to Commissioner Hamm.
"I am pleased that Blue Cross Blue Shield has agreed to give up its ability to unilaterally change payments," Hamm said. "This new contract will bring a significant change to the way Blue Cross Blue Shield does business with health care providers and institutions, and ensures the company will have to keep its promises."
Hamm continued, "The Department has been closely monitoring the financial health of the company during this period. Consumers can be assured that Blue Cross Blue Shield is in good financial shape."