Massachusetts's law was signed in July. Of course, states are seeing other violations, but it's the prompt-pay laws that get a large share of their attention, insurance regulators say. It was the largest fine levied for such a violation. Health plans say the money they are being fined could be put to better use. Those are sizable amounts of money that you're talking about.
Plans prefer to devote their resources to the care of their members.
When you've got costs that are attributable to this kind of activity, micromanagement in regulation or more lawsuits, you just don't see where it's helping patients. Increases in the amounts and frequencies of fines could mean that plans raise premiums for members or lower fee schedules for doctors. High in the news release announcing the HealthNow fine was an assurance that the company won't try to recoup the money in premiums. HealthNow operates as Blue Cross Blue Shield of New York in western New York and Blue Shield of Northeastern New York in Albany. N.Y. Lawfully, insurers generally can use only anticipated expenses for the coming year in setting rates, but New York regulators still made the company agree that the fine wouldn't be passed along in rate increases.