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Violation Tracker Individual Record

Company: LIFEWISE HEALTH PLAN OF WASHINGTON
Current Parent Company: Premera Blue Cross
Penalty: $250,000
Year: 2023
Date: May 16, 2023
Offense Group: consumer-protection-related offenses
Primary Offense: insurance violation
Violation Description: Consent Order with a Fine of $250,000 due to the Company incorrectly processing 4,133 telemedicine claims, impacting 871 consumers and 839 providers, the Company violated RCW 48.44.040. By incorrectly processing 6,591 COVID-19 claims in 2020 and 2020, the Company violated RCW 48.44.040, RCW 48.02.060(4), and WA-OIC Emergency Order No. 20-01. By incorrectly processing 314 COVID-19 claims in 2022, the Company violated RCW 48.44.014. By incorrectly advising on a member facing website that the Company and the provider had to agree to expedite member appeals, the Company violated RCW 48.43.530(5)(c) and WAC 284-43-3170(1)(b).
Level of Government: state
Action Type: agency action
Agency: Washington State Office of the Insurance Commissioner
Civil or Criminal Case: civil
Facility State: Washington
HQ Country of Current Parent: USA
HQ State of Current Parent: Washington
Ownership Structure of Current Parent: non-profit
Major Industry of Current Parent: healthcare services
Specific Industry of Current Parent: insurance; managed care
Source of Data: (click here)
Source Notes: If an online information source is not working, check the Violation Tracker Data Sources page for an updated link.
Current parent company note: Parent-subsidiary relationship is current as of the most recent revision listed in the Update Log.