BILLING NEWS

Blues must stop using 'most-favored nation' clauses

Blue Cross Blue Shield of Michigan must stop using "most-favored nation" clauses in their contracts with providers, the state insurance commissioner said in an order issued last week. The preferential hospital pricing policies, in which Blue Cross allegedly required hospitals to charge higher prices to competing insurers, also are banned for all insurers operating in Michigan unless Insurance Commissioner Kevin Clinton specifically approves them. "As of Feb. 1, 2013, any attempt by an insurer to enforce a most-favored nation clause in any provider contract, without the commissioner’s prior approval, is prohibited and will result in appropriate administrative action," Clinton said in the order. Despite the order, Blue Cross hasn’t yet decided whether it will stop using the most-favored nation policies because their benefits outweigh other issues.

SOURCE: Source
INDUSTRY NEWS TAGS: Blue Cross Blue Shield Michigan


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