According to the report, Scott Keefer, vice president of public affairs and communications at Blue Cross, said the claim was for prescription medication, and BCBS of Minnesota “was concerned the drug was being prescribed in a way that goes beyond its government-approved label.”
Though BCBS of Minnesota agreed with the prescription, it didn’t communicate its choice to an outside company that manages its pharmaceuticals. “There was a breakdown in communication,” said Mr. Keefer. “I acknowledge we could have done a better job in managing the follow-up.”
Mike Rothman, commissioner of the Minnesota Department of Commerce, said the denial was a “blatant violation.” “I will not tolerate these kinds of terribly troubling, unfair claims practices against consumers,” he added. “It is unprecedented that we would have found a violation of this nature, and issued a consent order with this penalty.”
According to the Minnesota Department of Commerce, consumers appealed over 400 decisions by Blue Cross and Blue Shield of Minnesota between 2011 and October 2015.
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