Blue Cross Blue Shield of Vermont has engaged the state in a reconciliation process to procure $6.2M the insurer said it paid in patient claims and is owed in premiums, reports Times Argus.
BCBCS claims the state owes the insurer unpaid premiums and incorrect payments because the state requires all individual policies be purchased through Vermont's Affordable Care Act insurance exchange, reports Times Argus.
This is the second year BCBS and Vermont have engaged in a reconciliation process. This year, the legal process concerns BCBS insurance plans sold on the state's insurance exchange in 2015.
BCBS used auditing firm KPMG to determine the amount the insurer is owed, director of government and public relations Cory Gustafson told Times Argus.
State chief of healthcare reform Lawrence Miller said the actual amount Vermont owes BCBS could be lower than $6.2 million. Mr. Miller said state officials are conducting an internal audit.