Thursday, January 29, 2009

Massachusetts Health Providers Investigated For Collusion

By Ethan Kalvin

Massachusetts Attorney General Martha Coakley has begun an investigation into the charges that Partners Healthcare and Massachusetts Blue Cross Blue Shield acted in collusion back in 2000, in a plan to deliberately cause health insurance rates to rise in the state. A Boston Globe investigative team originally reported on the case a few weeks ago.

The investigative reporting team from the Boston Globe reported that BCBS paid large premium increases over the years to Partners Healthcare, which would cover health care charges for their policyholders. Partners was to agree to seek similar high rates from other state insurance companies in the agreement. It was reported that Partners asked for $193 million over a three year period, but BCBS was wary of such a high amount because it could lead to significant rate increases for consumers. Partners reported their intent to go after similar large increases fromother insurers, so BCBS agreed to the deal.

Additionally, the Globe Spotlight reporting team discovered that BCBS continues to pay an estimated 30% more to hospitals which are owned by Partners Healthcare than they pay to other hospitals. After nine years, BCBS, the state's largest insurance carrier, is paying an estimated $2 billion yearly to Partners healthcare, the state's biggest health care provider.

Much of the money that is being paid to Partners Healthcare comes directly out of the pockets of the Massachusetts policyholders, unfortunately. By undertaking such an important investigation, the state attorney general is fulfilling an important role, through this examination of power abuse between major insurance providers and health care providers.

Partners Healthcare is the largest health care provider in the state. They own major Massachusetts hospitals including Brigham and Womens Hospital, Newton-Wellesley Hospital and Massachusetts General Hospital. They also operate as a teaching affiliate to Harvard Medical School.

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