Coordinated Care fined $100,000 for compliance failings

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The Office of the Insurance Commissioner fined Coordinated Care Corp. $100,000 for failing to follow the compliance plan it agreed to late last year regarding its provider network deficiencies and other ongoing issues.

The commissioner issued a cease and desist order Dec. 12 for the company to stop selling individual health plans in Washington state because it failed to maintain an adequate network of medical providers. The company was fined $1.5 million with $1 million suspended, pending no further violations over the next two years.

In particular, Coordinated Care admitted to not having enough anesthesiologists in King, Snohomish, Pierce and Spokane counties. According to the company’s own data, its provider network was seriously deficient in other categories of providers, including immunology, dermatology and rheumatology.

With the consent order in place, the order instructing the company to stop all sales was canceled. Since agreeing to the compliance plan, Coordinated Care has not met all of the milestones it agreed to in order to resolve its ongoing issues. For example, it has:

  • Failed to meet deadlines it committed to in the compliance plan;
  • Submitted provider contracts with illegal arbitration clauses; and
  • Failed to meet state requirements to show its provider networks are adequate.

The commissioner remains committed to working with Coordinated Care to correct its outstanding issues and will continue weekly discussions with the company to review its progress. If the company continues to violate the compliance plan it agreed to, some or all of the remaining $900,000 fine may be imposed.

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