Idaho lawmakers are digging into how the state might better regulate health insurance companies that poorly treat their customers and healthcare providers.
The newly formed Idaho Health Insurers Working Group is studying how poorly performing companies affect their customers’ health when they delay treatments and refuse to reimburse providers.
“A delay that may seem minor on paper can mean a long drive, missed work, postponed treatment or a worsening health condition for someone in our district,” said Rep. Dustin Manwaring (R-Pocatello), who co-chairs the group.
Manwaring’s own Pocatello district is facing these issues.
The state’s insurance provider, Regence, is in a contract fight with the city’s hospital, Portneuf Medical Center.
Their agreement ended in June, meaning anyone insured by Regence must now pay substantial out-of-network rates at Portneuf, excluding emergency care.
Faith Knowlton, who runs Idaho’s office of group insurance, told legislators Tuesday that Portneuf’s for-profit owners have asked for much higher reimbursement rates for their new contract.
Knowlton said the proposed rate hike would’ve affected every insured state employee.
“The entire 65,000 members would see a 7% increase [to their healthcare costs] to allow 3,000 members to stay in the network,” she said.
Regence said it’s continuing negotiations with Portneuf’s for-profit owners, Ardent Health Services, which owns more than 285 clinics and hospitals across the country.
Portneuf said in a press release from June that it had been negotiating in good faith with the insurance company.
“However, Regence denies a substantial portion of claims for care we provide, has millions of dollars in unpaid claims owed to Portneuf, and has taken the position that patients can seek care elsewhere rather than reaching a new agreement,” Portneuf said.
Lawmakers plan to further dive into the issue next month.
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