The Minnesota attorney general's office has settled its lawsuit with Blue Cross Blue Shield of Minnesota. Mike Hatch filed suit last October accusing the insurance carrier of illegally and systematically denying mental health coverage and shifting the cost to taxpayers.
UNDER THE TERMS OF THE SETTLEMENT, Blue Cross wilL pay the state $8.2 million, pay for its members' court-ordered treatment, agree to semi-annual audits by an attorney general appointee and improve coverage for eating disorder, autism and mental health problems. If the carrier initially denies coverage for those illnesses, Blue Cross has also agreed to abide by the decisions of an independent review panel.
Blue Cross agreed to the terms without admitting any wrongdoing. But Vice President Richard Neuner said the insurer will improve its coverage and customer service. "For nearly 70 years, we've been one of Minnesota's trusted names in health care. Are we perfect? Clearly not. Frankly, we have learned through these discussions with the Attorney General and from the issues raised, we can, and will do better," Neuner told a news conference.
The cornerstone of the settlement is the creation of a "fast-track appeals committee." Chief Deputy Attorney General Alan Gilbert said the three-person panel, comprised of representatives from the attorney general's office, Blue Cross and the Hennepin County chief judge's office, will act as a kind of appeals court when Blue Cross denies mental health coverage.
"Immediately that denial will go to the review committee which then will have one business day to determine whether to reverse or affirm that denial decision by Blue Cross. If the committee decides to reverse the decision, that granting of coverage is binding on Blue Cross," according to Gilbert.
The settlement was bittersweet for Kitty Westin, who was one of the original parents to join in the attorney general's lawsuit and go public with her case. Westin's daughter, Anna, died last year after battling anorexia. Kitty Westin says the changes Blue Cross has now agreed to make - improving its coverage for eating disorders - would've made a major difference in her daughter's treatment.
"One was just getting authorization for inpatient care. Another part was because insurance companies weren't recognizing eating disorders as serious medical illnesses that required specialized care; there's not a system set up that allows that to happen as well as it should be," Westin says.
Blue Cross and the attorney general say they'll review and try to resolve each of the individual claims - like Kitty Westin's - that were brought as part of the lawsuit.
Blue Cross is one of Minnesota's three largest health insurers. The other two are HealthPartners and Medica.