The Department of Insurance (DOI)
has entered into a Consent Agreement with Blue Cross Blue
Shield of Louisiana (BCBSLA)
and the company has paid a $150,000 stipulated fine for non-compliance
with state health care laws, according to Commissioner of Insurance
Jim Donelon.
The fine and the Consent Agreement
relate to approximately 150 instances of non-compliance with
the state law known as
the "Baby Bill." The bill, Act 269 of the 2004 Regular
Session of the Louisiana Legislature, requires health insurers
to notify the Department of Health and Hospitals (DHH) when
one of its insured's gives birth to a Medicaid-eligible baby.
DHH then conducts a cost analysis to determine if it would cost
the state less money to maintain the newborn baby on its parents'
health insurance plan and pay the baby's health insurance premium
rather than enroll the baby in Medicaid. DHH estimates the Baby
Bill can result in $10 to $20 million per year in Medicaid savings
to the state.
According to the Consent Agreement, BCBSLA failed to properly
notify DHH and other required persons and/or failed to provide
the required documentation or information on newborns qualifying
for coverage.
In addition to the $150,000 fine paid by BCBSLA, the company
has agreed to stipulated fines for any possible future violations
of $500 per day per violation.
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