Attorney General Peter F. Kilmartin today asked for reconsideration of a Decision of the Health Insurance Commissioner approving a rate increase requested by Blue Cross Blue Shield of Rhode ("Blue Cross") for its Direct Pay line of business. The Direct Pay market is for those who pay for their own coverage, without the help of employers, with the exception of those insured on the exchange who may qualify for Medicaid subsidies. The Commissioner's Decision will allow Blue Cross to increase rates by 10 percent beginning January 1, 2016.
Upon reviewing the Commissioner's decision, Attorney General Kilmartin determined it was necessary to file a Motion for Reconsideration on the grounds that the Order does not comply with a state law mandating that agency orders must contain "concise and explicit statement of the underlying facts supporting the findings of fact." Although the Hearing Officer's Report and Recommendation was 35 pages long, giving an in-depth explanation for the conclusions, the Commissioner's final decision that will result in a 10 percent increase was only two pages long, and contained no independent reasoning.
"The Order issued by the Health Insurance Commissioner did not provide any reasoning or support for her findings of fact, making it impossible for anyone to understand her rationale and file an appeal in Superior Court under the Administrative Procedures Act," said Attorney General Peter F. Kilmartin. "My priority is to protect the interests of the ratepayers, and it is imperative that all available information be made public so that the process can be transparent for all."
Further complicating the lack of transparency in this situation, it was brought to the attention of Blue Cross and Attorney General Kilmartin that the Commissioner had engaged in closed-door communication with one of the parties involved, without the knowledge of the other parties.
The Motion for Reconsideration respectfully requests that the Commissioner provide support for her Order, or alternatively, adopt the report and recommendations of the Hearing Officer in full.