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Group demands tighter scrutiny of insurers in state

  • Article by: JACKIE CROSBY
  • Star Tribune
  • August 23, 2012 - 10:03 PM

A citizens group is calling for closer scrutiny of the way the state's private insurance plans manage taxpayer dollars to provide health care for low-income and elderly Minnesotans.

In a report released Thursday, the Greater Minnesota Health Care Coalition accused the nonprofit HMOs of accumulating more than $824 million in excess profit since 1995 because no one was "minding the store."

The group's call for more transparency and accountability joins a string of questions directed at the health plans and Minnesota Department of Human Services from state and federal lawmakers.

A health plan association representative denied the latest charges. Officials with Gov. Mark Dayton and his predecessor, Tim Pawlenty, also have denied they acted outside the law.

Investigations are underway by congressional Republicans and the Justice Department into how the state set rates for Medicaid, the state-federal health insurance program covering the poor and disabled.

The Greater Minnesota Health Care Coalition, based in Mora, Minn., describes itself as a nonprofit, nonpartisan charitable organization, with 3,000 members in rural areas near Duluth, St. Cloud and Mora.

The group alleged four health plans -- Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica and UCare -- and the industry association engaged in "inaccurate and deceptive financial reporting ... and possibly fraudulent practices."

A spokeswoman for the Minnesota Council of Health Plans denied the accusations, saying state and federal agencies require different types of financial reports. "Any variation in data from one reporting entity to another is due to the different requirements of the entity requesting the information," said Eileen Smith. Margins on state public programs averaged less than 2 percent in the past decade, she added.

The state Department of Human Services is hiring an outside auditor to examine Medicaid rates between 2003 and 2011. The group said the audit should be more rigorous and cover more years.

A spokeswoman for Human Services Commissioner Lucinda Jesson said in an e-mail: "If additional information is identified that requires expansion of this effort, we will work with the Legislature to take necessary action."

Jackie Crosby • 612-673-7335

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