Minnesota Attorney General reaches settlement with Blue Cross Blue Shield of Minnesota

(KNOX) – Minnesota Attorney General Keith Ellison announced that his Office has reached a settlement with Blue Cross and Blue Shield of Minnesota regarding the accessibility of mental health services. The settlement aims to make Blue Cross’ mental health care services more accessible and transparent to many Minnesotans.

In June 2019, the Minnesota Attorney General’s Office began an investigation into Blue Cross’ compliance with Minnesota’s mental health parity laws. Minnesota law requires parity in the provision of mental and behavioral health services, and physical health services (Minn. Stat. 62Q.47). Under this statute, a company may not impose a treatment limitation that discriminates against mental health services in favor of physical health services.

The Office’s investigation preliminarily found that Blue Cross’ conduct may not have complied with mental health parity requirements. Blue Cross disputes that finding and maintains that it has at all times complied with the applicable statutes and regulations. This settlement resolves the Attorney General’s investigation into Blue Cross.

According to the terms of the settlement, Blue Cross and Blue Shield of Minnesota will:

• Make decisions about the vast majority of requests for prior authorization for behavioral health services within 5 days. For at least 95% of prior authorization requests for behavioral health services that are subject to standard review, Blue Cross will process, make decisions, and communicate those decisions to providers and enrollees within five business days of the date that Blue Cross receives all information reasonably necessary to make a determination about the request.
• Approve or deny a behavioral health provider’s request to join Blue Cross’ network within 45 days. Blue Cross will process, make the credentialing determination, and communicate that determination to the provider all within 45 days of receipt of a clean application from that provider. This should make it easier for Blue Cross to quickly scale up their capacity to provide behavioral healthcare.
• Implement initiatives to increase behavioral healthcare access and provide data to the Attorney General’s Office to evaluate the success of those initiatives. Blue Cross will share information, including nonpublic trade secret information, which the Minnesota Attorney General’s Office will use to evaluate the success of Blue Cross’ initiatives to expand access to behavioral healthcare services.
• Pay a consultant selected by the Office who will review and advise the Office on the Nonquantitative Treatment Limitations Comparative Analyses BCBS will create and provide to the Office, to ensure BCBS is not imposing more restrictive limitations on mental health/substance use benefits than on medical/surgical benefits in the same classification.
• Respond within 30 days to any complaint about behavioral health parity submitted to the Minnesota Attorney General’s Office, which will significantly improve transparency in the care many Minnesotans receive. Minnesotans can submit complaints about their healthcare services using the Attorney General’s online Consumer Assistance Request Form.

In addition to these terms, Blue Cross will voluntarily contribute $600,000 to Minnesota State University-Mankato for use by the Center for Rural Behavioral Health, whose mission is to increase access to behavioral health services in greater Minnesota.

“Mental and behavioral healthcare is healthcare, period,” said Attorney General Keith Ellison. “We expect someone with a broken leg to be able to get the care they need, and the same should be true of Minnesotans struggling with conditions like depression or substance use disorder. I am pleased we were able to reach this agreement with Blue Cross to expand access to behavioral health services for Minnesotans across our state who use Blue Cross. My mission is to help folks afford their lives and live with dignity, safety, and respect, and improving the people of Minnesota’s healthcare is fundamental to that mission.”

In the settlement, Blue Cross also agreed to a stayed civil penalty of $300,000. Blue Cross will be required to pay that sum to the state of Minnesota if they are found by a court to have violated the terms of the settlement. The settlement lasts until December 31, 2028.

Minnesotans with complaints about healthcare services can share those complaints with the Attorney General’s Office using this online form. The Office can also be contacted by phone at (651) 296-3353 (Metro area) or (800) 657-3787 (Greater Minnesota).