California insurance commissioner slams rate hike by Anthem Blue Cross
04 Apr 2013
California insurance commissioner Dave Jones on Tuesday slammed another double-digit rate hike thousands of small businesses would have to bear for taking their insurance from industry giant Anthem Blue Cross.
This time though, help for Jones came from a surprising source. He had referred to the Consumer Watchdog, his political ally and a vehement industry critic, to help review health insurance rate increases under a one-year contract worth as much as $88,000.
The insurance industry was considerably roiled by the state seeking help from its longtime nemesis to review rate increases, while a number of experts questioned whether it was necessary to further antagonise insurers at a time when state officials were trying to work closely with the industry to implement a massive healthcare expansion.
Public-policy experts were also considerably displeased with the arrangement.
According to Jessica Levinson, a Loyola Law School professor and expert on government ethics, the very aggressive stance against insurance companies raised serious questions about a conflict of interest. She said an independent researcher was needed.
According to Patrick Johnston, president of the insurance trade group California Association of Health Plans, any review of health plan rates should be conducted by independent, impartial consumer groups that did not have political conflicts of interest and financial motivations.
Meanwhile, Anthem Blue Cross Blue Shield of Ohio is being helped by University of Cincinnati Health to amend the current healthcare contract and extend its time frame.
There have been differences between the two institutions over contract changes, reimbursement and claims that are affecting the contract negotiations.
The two organisations are currently in negotiations over UC Health's need for adequate reimbursement for doctors' services.
A ''fair and reasonable contract'' had been put forward by UC Health for the reimbursement rates and if Anthem were to accept then both companies would move ahead and continue the contract, according to a statement released by UC Health on 29 March.
The increase for reimbursement of doctors' services UC Health was requesting included pay for physicians, training, specific practices and staff employment.
According to UC Health spokesperson Diana Lara, UC Health would be better able to attract and attain the best researchers and the best physicians both nationally and internationally.
In order for UC Health to be able to attract those researchers, it had to be able to be competitive in what it offered, failing which they would go somewhere else, she added.
UC Health, already the most highly reimbursed hospital system in Greater Cincinnati, is demanding their physicians be paid more than other local physicians, a statement released by Anthem said.
