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Wash. insurance regulator fines Centene unit over provider network issues

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Wash. insurance regulator fines Centene unit over provider network issues

Centene Corp. unit Coordinated Care Corp. has agreed to fix its provider network deficiencies and other ongoing issues and pay a $1.5 million penalty with $1 million suspended, pending no further violations over the next two years.

With the recent consent order in place, the cease-and-desist order instructing Coordinated Care to stop selling individual health plans in Washington has been canceled.

Washington Insurance Commissioner Mike Kreidler on Dec. 12 ordered the company to stop all sales because it failed to maintain an adequate network of medical providers. Coordinated Care admitted to not having enough anesthesiologists in King, Snohomish, Pierce and Spokane counties. The company's provider network is also "seriously deficient" in other categories of providers, including immunology, dermatology and rheumatology, based on its own data.

Centene disclosed that the agreement with the insurance commissioner was related to Coordinated Care's Ambetter product.

"We will continue to work closely with the [Office of the Commissioner], including continuing to make refinements and improvements to our network reporting processes," Centene said in a news release. "We are committed to address known issues in our network in select regions of the state, and we have taken actions to ensure our members have access to these services."