|
Georgia Insurance Commissioner John W. Oxendine has fined six more HMOs a total of $375,000 for violating the state's prompt-pay law. The latest offenders are Aetna U.S. Healthcare, Blue Cross and Blue Shield of Georgia, Blue Cross and Blue Shield Healthcare Plan of Georgia, CIGNA HealthCare, Coventry Health Care, and Prudential HealthCare.
This is the fourth time this year that Oxendine has taken Georgia HMOs to the woodshed for delaying claims payments to doctors. So far, Oxendine has fined:
- Aetna U.S. Healthcare, $50,000
- Blue Cross and Blue Shield of Georgia, $91,000
- Blue Cross and Blue Shield Healthcare Plan of Georgia, $44,000
- CIGNA HealthCare, $80,000
- Coventry Health Care, $10,000
- Humana Employers Health Care of Georgia, $400,000
- One Health Plan, $200,000
- Prudential HealthCare, $100,000
- UnitedHealthcare, $150,000
The fine is the latest in a series of penalties against HMOs that have resulted from ongoing reviews by the Georgia Department of Insurance (DOI) of claims data that HMOs are required to submit to the DOI quarterly. Georgia law requires that managed care plans pay claims within 15 working days, or notify the provider or policyholder why a claim can't be paid.
According to Oxendine, the DOI has seen some improvement in claims handling since it started examining claims data for prompt-pay violations in 1999. "I expect that improvement to continue," he says.
In August 1999, Oxendine issued a directive to all health plans licensed in Georgia that his office would begin examining claims data every quarter. To date, no HMO that has been reviewed has been in 100 percent compliance with the law. HMOs have been repeatedly warned by the commissioner that nothing less than full compliance is expected.
|
British Citizens:
Canadian Citizens:
