Regence BlueShield has been ordered to pay $148,000 for wrongly denying coverage of prescription birth control to almost 1,000 women, reports the Seattle Post-Intelligencer.
Washington's Insurance Commissioner office said Regence denied coverage of removing intra-uterine devices for more than eight years for a variety of reasons, including: "Condition not covered by this contract," "This service for this condition is not covered by your plan," and "Medical necessity for this service or supply has not been established." Under state law, insurance companies are required to provide comprehensive prescription drug coverage for prescription contraceptives, according to the Insurance and Financial Advisor.
Three of the women who were denied coverage appealed to Regence, but it upheld the denials. One woman then contacted the state insurance commissioner's office, which investigated the denials, reports the Seattle Times.
The complaint alerted the company that it had been incorrectly processing claims for this procedure, Regence spokeswoman Rachelle Cunningham told the Times. "While the company has always covered birth control as part of its standard benefits, it had mistakenly coded the removal of these particular devices, which resulted in denied claims," she said. "Regence immediately reprocessed affected claims and changed its policies to ensure compliance" with guidelines of the insurance commissioner's office. Cunningham added that the error affected fewer than one-tenth of 1 percent of those insured by Regence in Washington.
A total of 948 women who were denied coverage for the prescription birth-control services will share in the money, according to the Insurance and Financial Advisor.
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