Dec 15, 201704:53 PMBlog

State fines health plan for thin network

Dec 15, 2017 - 04:53 PM

More than 140 consumers filed complaints with Washington’s Insurance Commissioner over lack of available medical providers in Pierce, King, Snohomish and Spokane Counties. In response, state officials today announced a consent order against Coordinated Care Corp. that includes a $1.5 million fine, although $1 million is suspended.

A Cease and Desist order had been filed this week that ordered the company to stop selling individual health plans in the state because it failed to maintain an adequate network of medical providers. This “Stop Selling” order is cancelled now that the insurance company has acknowledged its shortcomings.

In particular, Coordinated Care admitted to not having enough anesthesiologists in Washington’s urban areas, and acknowledged that its provider network is seriously deficient in other categories, like immunology, dermatology and rheumatology.

State regulators have been working with the provider since mid-May and they report that anyone with coverage from this insurance plan who has received a surprise medical bill from them, should contact the Insurance Commissioner office.

Coordinated Care has the third-largest market share in Washington’s HealthPlan Exchange with 38,00 persons enrolled as of September 2017.

            

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