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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

May 14, 2014 at 12:44 PM

Kreidler removes hearings officer in Seattle Children’s case

Update| 5:25 p.m.:

Insurance Commissioner Mike Kreidler has removed his hearings officer from adjudicating insurance cases, including the Seattle Children’s case currently under way.

Deputy Commissioner Steve Valandra said Wednesday that Kreidler revoked Chief Presiding Officer Patricia Petersen’s delegation of authority, and the agency would immediately begin the search for another hearings officer. Petersen is on paid leave, Valandra said.

“We want to make sure we maintain a fair and impartial process going forward,” he said. “She’s made claims and I can’t really say more until the process plays out.”

The insurance office, like other state agencies, delegates an officer to hear disputed cases. Appeals go to Superior Court.

 

 Original post:

The Office of the Insurance Commissioner’s hearing officer has chastised Chief Deputy Insurance Commissioner James Odiorne for improperly attempting to influence her on issues coming before her in cases involving the adequacy of insurers’ networks.

According to the notice filed Tuesday by Chief Presiding Officer Patricia Petersen, Odiorne last year “repeatedly attempted to discuss the significant issue (network adequacy) and impose his opinions and influence my decisions in the Coordinated Care case.”

In that case, Seattle Children’s hospital was attempting to force Coordinated Care, a health-insurance company, to include the hospital in its provider network. That case evaporated earlier this year when Coordinated Care and Children’s came to an agreement to include the hospital in the insurance network.

Petersen said Odiorne’s attempts continued up until about a month ago. A current case, brought by Seattle Children’s against two additional insurers, BridgeSpan Health Company and Premera Blue Cross, involves similar network issues.

Petersen said Odiorne told her she should decide cases the way Insurance Commissioner Mike Kreidler wants the case decided; she said she told him that if she did that, there would be no reason for a hearing.

Stephanie Marquis, spokeswoman for the Office of the Insurance Commissioner, said:  “We do not generally comment on pending cases and would prefer to let the order work is way through the legal process.”

Petersen said she was not influenced by Odiorne, and suggested that she remain as presiding officer in the ongoing case.

Comments | Topics: BridgeSpan Health Co., James Odiorne, network adequacy

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