Follow us:

HealthCare Checkup

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

Topic: network adequacy

You are viewing the most recent posts on this topic.

June 18, 2014 at 2:49 PM

Seattle Children’s argues in favor of rulings by embattled OIC judge

OIC Chief Presiding Officer Patricia Petersen testifying before the Senate's Law and Justice Committee. TVW

OIC Chief Presiding Officer Patricia Petersen testifying before the Senate’s Law and Justice Committee. TVW

Seattle Children’s hospital on Tuesday made another move in the high-profile legal tussle over which facilities and doctors must be included in insurance plan networks in order to adequately protect customers.

The case — already significant because of the importance of the network adequacy debate — became even more controversial following allegations that the judge overseeing the dispute has been unfairly influenced. The allegations came from the judge herself, Patricia Petersen, chief presiding officer at the Office of the Insurance Commissioner.

The controversy started last summer, when the OIC approved insurance plans to be sold in Washington’s health insurance marketplace. Those plans included ones that did not have Seattle Children’s in their coverage. In response, the hospital demanded a hearing with OIC, arguing that the plans are inadequate for failing to include their facility because of the unique services provided there.

There has not been a hearing yet, but from December to early May, Petersen has issued orders concerning the case.

More

Comments | Topics: health insurance, Mike Kreidler, network adequacy

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,…

More

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

April 23, 2014 at 7:20 PM

Coordinated Care adds Seattle Children’s to network

Coordinated Care Health, whose “Ambetter” plans are sold through the Washington Healthplanfinder, has added Seattle Children’s to its network of providers. The insurer took a lot of heat last year for not including Seattle Children’s, which sued last year to force the insurance commissioner to require plans to include Children’s, arguing that it has unique services…

More

Comments | Topics: Coordinated Care, Healthplanfinder, network adequacy