Colorado's top insurance regulator says he almost ordered Bright Health to cease all operations in the state following dozens of consumer and provider complaints.
An April 11 interview between Colorado Division of Insurance Commissioner Michael Conway and The Denver Gazette revealed that a $1 million fine imposed on the Minneapolis-based payer is meant to create a solution for the highlighted issues without harming Bright Health's Colorado beneficiaries.
"It was essentially a cease-and-desist order review analysis. That would have required Bright Health to completely stop acting as an insurance company in the state of Colorado. That would have been extremely detrimental to those folks who have Bright Health insurance coverage right now. I think about all those people who have paid through their deductibles and that have their doctors lined up through Bright Health," Mr. Conway said. "I was really holding them accountable for the mistakes they had made, but then also putting an incentive — a fairly large incentive — in place for them to get everything back in order, and to make sure going forward they have solutions."
On April 8, the division fined Bright Health $1 million after it received more than 100 consumer and healthcare provider complaints starting in 2021 that indicated systemic operational problems: failure to pay provider claims according to Colorado law, failure to communicate with members, an inability to accurately process consumer payments and accounts, and untimely process of claims for physical and behavioral health problems.
Only half the fine must be paid now depending on operational improvements from Bright Health and compliance with various metrics.
On April 14, the payer said it would stop offering insurance plans in six states after 2022.