DC investigates CareFirst provider contracts

The D.C. attorney general's office has begun investigating whether metro DC-area health plan CareFirst has structured its contracts with providers to give it an unfair advantage over competitors. The health plan's CareFirst Blue Cross Blue Shield network serves 1.2 million consumers in the District, Northern Virginia and two Maryland counties.

DC Attorney General Linda Singer is particularly focused on whether CareFirst is making improper of a contract clause--generally known as a "most favored nation" provision--which demands that CareFirst automatically get any low rates providers negotiate with competing health plans. To research the question, Singer has asked a judge to order CareFirst competitor Kaiser Foundation Health Plan to turn over information on its rates. (I'll bet Kaiser execs were thrilled.)

To find out more about the investigation:
- read this article in The Washington Post

Related Article:
MedChi protests CareFirst rate cuts. Report

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