Blue Cross Blue Shield fined for improperly denying claims

BISMARCK, N.D. (AP) — North Dakota Insurance Department announced Tuesday it fined the state's largest provider of health insurance $125,000 for improperly denying some claims and not reporting suspected cases of fraud.

Insurance Commissioner Jon Godfread said the 16-month investigation of Blue Cross Blue Shield of North Dakota focused largely on mental health and substance abuse claims. Some of the claims were improperly denied and there was "disagreement on the treatment level" of others, he said.

Under a 2008 federal law, health insurers are required to treat mental illness and substance abuse the same as other conditions. Jeff Ubben, the insurance agency's deputy commissioner and general counsel, said Blue Cross Blue Shield of North Dakota was not in compliance with the parity law.

Godfread said Blues has been "extremely cooperative" with regulators and has "fixed problems proactively as we found them."

Read more: https://bismarcktribune.com/news/state-and-regional/blue-cross-blue-shield-fined-for-improperly-denying-claims/article_a0edef10-1667-5adc-8b47-3991b5381cdd.html