Coordinated Care Corp. fined $100,000 for failing to follow compliance plan

(Olympia, WA – Insurance News 360) – On March 22, Coordinated Care Corp, known as Coordinated Care, was fined by the Washington Office of the Insurance Commissioner, for approximately $100,000, after the organization failed to follow a compliance plan agreed to on Dec. 15, 2017. THe plan was in regard to problems with its provider network and other issues.

The company was originally ordered to stop selling individuals health plans in the state after they did not maintain an adequate network of medical providers – they were originally fined $1.5 million, with $1 million suspended if they had no violations in 2018 and 2019.

In particular, Coordinated Care admitted to not having enough anesthesiologists in King, Snohomish, Pierce and Spokane counties. The company’s own data showed that the provider network was seriously deficient in other categories of providers, including immunology, dermatology and rheumatology.

With the consent order in place, the order instructing the company to stop all sales was canceled. But, in the past three months, the organization has not met all of its milestones to fix problems. In particular, the state says Coordinated Care has failed to meet deadlines laid out in the compliance plan; it has submitted provider contracts with illegal arbitration clauses; and it has failed to meet state requirements that prove the adequacy of provider networks.

The OIC remains committed to working with Coordinated Care to correct its outstanding issues and will continue weekly discussions with the company to review its progress. If the company continues to violate the compliance plan it agreed to, some or all of the remaining $900,000 fine may be imposed.

Source: Office of the Insurance Commissioner, Washington State.

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