Direct Pay increase authorized

Blue Cross & Blue Shield of Rhode Island has been authorized to raise its Direct Pay rates by an average of about 7 percent, effective April 1.
The hike, approved by Health Insurance Commissioner Christopher F. Koller, will affect about 14,000 individuals who buy their coverage directly from Blue Cross. It would be the first increase since 2008; last year, Koller refused to grant any hike at all, though Blue Cross wanted to raise rates by 5.9 percent.
This time, Blue Cross sought a 10.2 percent average hike, then agreed to reduce it to 9.5 percent after making a deal with Attorney General Patrick C. Lynch’s office, which acts as a consumer advocate in Direct Pay rate hearings. The deal was filed as a stipulation in the case late last month, effectively deciding the case for the hearing officer, John A. Cogan Jr., Koller’s executive assistant for policy and program review.
Koller himself, however, isn’t bound by stipulations – he just has to base his decision on the information presented at the hearing. Koller last week issued an order requiring Blue Cross to pare its rate hike down below the agreed-upon level, saying the stipulation had inadequately addressed Blue Cross’ obligation to “employ pricing strategies that enhance the affordability of health care coverage.”
Lt. Gov. Elizabeth H. Roberts, who had previously spoken out against both the original rate hike request and the compromise with Lynch, said that while she was “encouraged” by Koller’s action, she still considered the hike “a tremendous financial burden for Rhode Islanders fighting for economic survival.”
The insurer can accept Koller’s decision or it can appeal in Superior Court. &#8226