Centene subsidiary faces $500k fine after Washington commissioner bans, then allows sale of narrow network plans

On Dec. 12, Washington state's insurance commissioner issued a cease and desist order against Coordinated Care Corp., a wholly-owned subsidiary of Centene Corp., due to an inadequate provider network for its individual policies. While it was lifted Dec. 15, Centene faces a $500,000 fine for selling plans with too narrow of networks.

Here are three things to know.

1. The Centene subsidiary admitted to not including enough anesthesiologists in four Washington counties where it sold plans. "According to the company's own data, its provider network is also seriously deficient in other categories of providers, including immunology, dermatology and rheumatology," Insurance Commissioner Mike Kreidler said.

2. Mr. Kreidler's office took in more than 140 complaints from Coordinated Care members this year regarding trouble accessing in-network providers and surprise medical bills. 

3. On Dec. 15, the Centene subsidiary agreed to a consent order to address network deficiencies. This ended the cease and desist order, but the payer could face another $1 million in fines if additional violations occur in the next two years. 

More articles on payer issues:
Humana, 2 equity firms in advanced talks to buy Kindred Healthcare: 4 things to know
Cigna expands digital portfolio with acquisition of Brighter
5 payers in the headlines

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Top 40 articles from the past 6 months