Blue Cross & Blue Shield of Rhode Island (BCBSRI), Care New England (CNE) and the Office of the Health Insurance Commissioner (OHIC) announced today that they have agreed to a settlement related to outstanding litigation involving the three parties. CNE originally brought its action after challenging the authority of the OHIC in a number of areas, including OHIC's nullification of a provision in the CNE – BCBSRI contract. A July decision against CNE by Superior Court Justice Silverstein led CNE to appeal the ruling in Supreme Court. The settlement announced today includes the withdrawal of the Supreme Court appeal and the replacement of the nullified provision in the BCBSRI contract with CNE.
The CNE litigation stemmed from an Examination OHIC conducted of BCBSRI regarding terms of its contract with CNE. The settlement announced today is consistent with the findings and order resulting from the Examination, which OHIC also released today.
Dennis Keefe, President and CEO of CNE, said that it was critical for such key parties in the state's healthcare community to negotiate a fair solution outside of court.
"We have to find ways to work together," Keefe elaborated. "The success of healthcare reform in Rhode Island depends on it."
Christopher F. Koller, Health Insurance Commissioner, said "I am pleased that OHIC's Examination authority has been upheld. CNE and BCBSRI leadership have worked hard and in good faith to develop new contract terms that are consistent with the Examination Order, the public interest and the Health Plan/Hospital contracting conditions set forth by OHIC."
BCBSRI President and CEO Peter Adruszkiewicz commented, "BCBSRI is pleased to have a resolution in this matter. The collaboration between the three parties is testament to the efforts each is making to provide Rhode Islanders with access to high-quality healthcare to help moderate long-term healthcare costs."
Copies of the OHIC Examination and Order regarding BCBSRI's contract with CNE and the settlement letter are available at www.ohic.ri.gov.