Oxendine takes aim at insurer

ATLANTA --- Georgia's largest health insurer has such a strong hold on the market that hospitals can't make better deals with other insurers, which is raising flags for the state's insurance commissioner, a newspaper reported Monday.


A routine clause in the contract that Blue Cross Blue Shield of Georgia signs with hospitals means the company's customers get the lowest prices for hospital stays and related expenses. But some say it also allows Blue Cross to restrain competition and keep prices high, The Atlanta Journal-Constitution reported.

"To have contracts that legally prevent someone from lowering their health care costs ... that's pretty unconscionable," said state Insurance Commissioner John Oxendine.

Oxendine said such contractual requirements aren't legal in Georgia. In July, he told Blue Cross and other insurers to rid their contracts of such clauses.

Blue Cross refused and instead sued Oxendine, claiming that not only are the clauses legal, but they're also beneficial to consumers. That case is pending.

Blue Cross, which has 2.5 million members in Georgia, declined to comment.

The clauses are known as "most favored nation" or "most favored customer" provisions. They are coming under attack across the country as health care costs rise.