Thursday, January 29, 2009

Boston Globe Uncovers Possible Insurance Company Collusion

By Ethan Kalvin

An investigative reporting team for the Boston Globe recently uncovered a possible collusion case involving Blue Cross of Massachusetts and Partners Healthcare. The accusation involves the making of deals off the record in 2000 designed to raise health care rates across the state. Massachusetts Attorney GeneralMartha Coakley has begun an investigation into the matter.

The Boston Globe has reported that BCBS of Massachusetts has paid significant increases over the years to Partners Healthcare to cover policyholder health care. In the agreement, Partners would agree to seeking payment hikes of comparable size from other insurance companies in the state. Partners allegedly asked for $193 million over three years, but BCBS balked because it would raise rates too much for consumers. But Partners agreed to go after similarly large sums from other insurers, so BCBS of Massachusetts agreed with the deal

The Boston Globe Spotlight investigative team reported that BCBS continues to this day to pay an estimated 30% more to Partners Healthcare hospitals than it pays to other hospitals. Nine years after the scheme began, the state's largest insurance carrier is paying an estimated $2 billion annually to the state's largest health care provider.

Much of the money that is being paid to Partners Healthcare comes directly out of the pockets of the Massachusetts policyholders, unfortunately. By undertaking such an important investigation, the state attorney general is fulfilling an important role, through this examination of power abuse between major insurance providers and health care providers.

Partners Healthcare operates as a teaching affiliate to Harvard Medical School, and are the largest health care provider in the state. They own and operate Massachusetts General Hospital, Newton-Wellesley Hospital and Brigham and Womens Hospital. - 16955

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