Monday, August 15, 2011

Kreidler fines Regence $100,000 for not covering contraceptives

About a year ago we told you of how Regence BlueShield unfairly denied contraceptive coverage to nearly a 1,000 women.

Today, we fined the company $100,000 for violating state law.

Washington State Insurance Commissioner Mike Kreidler learned of the denial from a consumer who called his office to complain. Regence covered the insertion of her contraceptive of choice -the intrauterine contraceptive device (IUD) but denied her claim for the cost of it removing it.

According to Regence, removing an IUD was not "medically necessary" simply because the device was outdated or the woman wanted to become pregnant. The company was ordered to reprocess all similar 984 claims from Jan. 1, 2002-May 25, 2010, totalling $148,740.37.

In addition to the $100,000 fine, Regence also must pay 8 percent interest to the policyholders on each the claims that were improperly denied. Here's a link to our order.

So what's the lesson here? If you believe your health insurer is treating you unfairly, give us a call (1-800-562-6900) or file a complaint online. Of the 984 women who were denied coverage by Regence, only three appealed the decision -- and all the denials were upheld. One woman's call to our office resulted in coverage for nearly a thousand other women.