Blue Cross Settlements

Anthem Blue Cross Settlement Discussions with the California Department of Managed Health Care

WOODLAND HILLS, Calif., July 7 /PRNewswire/ -- "For several months, senior leadership at Anthem Blue Cross has been actively working on a settlement agreement with the California Department of Managed Health Care to bring closure to all issues relating to previous rescissions.

Following are the key elements of our settlement proposal:

-- We have offered immediate reinstatement of the seven individuals the Department originally asked us to reinstate.

-- We offered to proactively reach out to all others whose coverage rescission were under review by the Department, and offered, at our expense, expedited independent third party reviews using the standard of review which the Department proposed. We have agreed to accept, as final, the decision of the third party reviewer. In any case where it is determined the individual's rights may have been violated, Anthem would pay all out of pocket expenses and offer coverage on a prospective basis.

-- We have been in discussions with the Department regarding a fine and have expressed willingness to settle on terms comparable to all other industry agreements.

-- In addition, Anthem offered to contribute sufficient funds to the state's high risk pool, to eliminate in its entirety the waiting list for coverage so that those in need will have access to health care thereby helping to address one of the state's most pressing health care issues.

Anthem Blue Cross is confident that all aspects of our offer are equal or superior to the agreements that have been reached recently between our peer health plans and the Department. We are hopeful that we can conclude these discussions in a manner that will be fair and equitable for all concerned.

"Separately, we have reached an understanding with California hospitals on behalf of individuals under which the hospitals will no longer pursue reimbursement from individuals whose policies were previously rescinded," stated Leslie Margolin, president of Anthem Blue Cross.