Did Alabama Blues get special treatment because of its size?
Blue Cross Blue Shield of Alabama, which controls about 90 percent of the state's health insurance market, is exempt from two recently signed bills that prohibit insurers from setting prices for non-covered dental and optometry care, the Birmingham News reported.
The bills specifically say that the rules do not apply to Blue Cross, which suggests that it is receiving special treatment, says Michael O'Malley, executive director of the Alabama Association of Health Plans, which doesn't represent Blue Cross.
"I've been in the Alabama market for more than a decade," O'Malley told the newspaper. "Blue Cross Blue Shield has always been a monopoly, but this is the first time they're acting like one."
Given the mammoth market share held by Blue Cross, which makes Alabama the least competitive statewide health market in the country, as FierceHealthPayer previously reported, O'Malley is concerned that this sign of preferential treatment will continue to keep more insurers away from the market.
But Republican state Sen. Jim McClendon worked on the optometry bill and said it excluded Blue Cross simply because the company doesn't set prices for services that aren't covered in its plans. However, he did acknowledge that Blue Cross did receive special consideration when lawmakers were drafting the legislation.
Blue Cross agreed that it received no preferential treatment. "The language in the legislation that passed was drafted by the dental and optometric community and presented to us in that form," Blue Cross spokeswoman Koko Mackin told the Birmingham News. "The section relating to Blue Cross was an acknowledgement that the company did not utilize this business practice with its providers and should not be included in the legislation."
Regardless of whether Blue Cross received special treatment, Republican state Sen. Paul Bussman, who sponsored the dental bill, said that the insurer will likely face more scrunity in the future because of its size.
To learn more:
- read the Birmingham News article
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