Blues' conversion not so easy anymore. (Blue Cross/Blue Shield).After years of successful conversions by nonprofit A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive. Nonprofits are also called not-for-profit corporations. Nonprofit corporations are created according to state law. Blues plans, the rejection of Maryland-based CareFirst, Inc.'s request to convert last March was a clear signal that regulators and consumers are now closely scrutinizing the transactions. Throughout 2003, four Blues plans either had their conversions blocked or voluntarily pulled out of the deal. When he made the decision, former Maryland Insurance Commissioner Steven Larsen said CareFirst had breached its fiduciary duty Noun 1. fiduciary duty - the legal duty of a fiduciary to act in the best interests of the beneficiary legal duty - acts which the law requires be done or forborne . The conversion would have led to an acquisition by WellPoint Health Networks Inc., and Larsen accused the company of choosing a bidder based on willingness to provide merger incentives or executive bonuses. He also argued that the company had enough money to fund capital expenditures, even though CareFirst said it needed access to capital to survive. His decision was followed by a ruling from the Kansas Supreme Court The Kansas Supreme Court is the highest judicial authority in the state of Kansas based in Topeka. Composed of seven justices, led by Chief Justice Kay McFarland, the Court supervises the legal profession, administers over the judicial branch, and serves as the state court of last that unanimously upheld former Insurance Commissioner Kathleen Sebelius' rejection of Blue Cross & Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. of Kansas Inc.'s bid to convert and be acquired by Anthem Inc. Sebelius had argued that a conversion would have resulted in a decline in surplus and premium rate increases. The close scrutiny by regulators continued in North Carolina North Carolina, state in the SE United States. It is bordered by the Atlantic Ocean (E), South Carolina and Georgia (S), Tennessee (W), and Virginia (N). Facts and Figures Area, 52,586 sq mi (136,198 sq km). Pop. , and resulted in a decision last July by Blue Cross and Blue Shield of North Carolina to withdraw its conversion plan, saying regulators' restrictions wouldn't have created a level playing field See net neutrality. . And in August 2003, Horizon Healthcare Services, Inc. said it would remain not-for-profit after nearly two years of considering conversion, citing a changed regulatory climate regulatory climate The extent to which a regulated firm or industry is permitted to earn an adequate return on the stockholders' investment. This term is nearly always used in reference to utilities, which are required to obtain approval for rate changes. and the North Carolina Blues decision. The actions came after three years of successful conversions. From 1999 through 2002, six plans converted. Three--Blues plans in New Hampshire New Hampshire, one of the New England states of the NE United States. It is bordered by Massachusetts (S), Vermont, with the Connecticut R. forming the boundary (W), the Canadian province of Quebec (NW), and Maine and a short strip of the Atlantic Ocean (E). , Colorado/Nevada and Maine--were acquired by Anthem. A fourth, in Wisconsin, merged with United Wisconsin Services to become Cobalt Corp. Two others--WellChoice and RightChoice, a unit of Blue Cross & Blue Shield of Missouri--launched initial public offerings. But in the late 1990s, the Blues plans that converted were struggling financially. and regulators' main concern was whether or not they would stay solvent without conversion, said Dawn Touzin of the consumer advocacy group Community Catalyst. Today, Blues plans, both for-profit and nonprofit, are posting profits. Another influence is the trend toward health-impact studies that look at the public impact of the transactions. "In Kansas, the investors thought it was a great idea," Touzin said. "But when [regulators] tried to look at it more deeply, they saw a conversion would result in an increase in rates, particularly for small businesses and individuals." The same thing happened in North Carolina, where a health-impact study found that rates would go up. In addition, regulators and consumer advocates look at the in, pact of those conversions from the 1990s. In Maine, Anthem acquired the Blues plan in 2000 and then became a public company in 2001. Since then, Anthem has tried to eliminate or soften consumer protections such as guaranteed issue, community rating, renewal requirements and mental health parity, according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. Community Catalyst. Insurers have argued that the regulations and mandates raise the cost of health care. 
Thanks for the info. I am trying to find out who owns Blue Cross Blue shild of South carolina as their division Trailblazers is paying my claims 12 times on phoney numbers and the doctor is getting one of them. Over a billion dollar theft and no investigation is yet allowed. Your report sounds sike Gov. Sibelius may be what is needed as Sec of HHS. I just want the crimes against, me, my doctor and the taxpayer to stop. as it is an overpayment that They will not stop. Their provider line employees have been caught in one lie after another trying to mislead billing clerks into going along with their fraud. So, who is the real owner at the top of all of this? |
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