BCBS changing provider contract

BISMARCK — Insurance Commissioner Adam Hamm says Blue Cross Blue Shield of North Dakota has agreed it will not unilaterally cut payments to health care providers.

Hamm said the Blues’ provider contract had allowed the payments to be cut at any time. He said that was one factor in his decision to deny the insurer’s request for a 14.9 percent rate increase for group policies, and a separate request for a 14.8 percent increase in premiums for the bank depositor group, which represents individuals.

The Blues’ decision to give up the ability to unilaterally change provider payments is a significant change in the way the state’s largest insurer does business, Hamm said Monday. It “ensures the company will have to keep its promises,” he said.

“The department can now properly review the rate increase requests and I can make a decision on them,” Hamm said. “This allows for all parties to move forward.”

Blue Cross Blue Shield has appealed Hamm’s earlier denial of its rate increases. Hamm said both sides have submitted brief to an administrative law judge who will make a recommendation on that later.

Hamm and Blues spokeswoman Denise Kolpack said discussions are continuing. Hamm said an agreement on the rate increases could be reached before an administrative law judge makes a recommendation.

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