Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, June 20, 1995 TAG: 9506210050
SECTION: BUSINESS PAGE: B-5 EDITION: METRO
SOURCE: ASSOCIATED PRESS
DATELINE: RICHMOND LENGTH: Medium
Attorney General Jim Gilmore sharply rebuked the state's largest health care provider Monday, saying the company continues to be deceptive even after paying nearly $30 million in fines and restitution.
Trigon Blue Cross Blue Shield, which insures 1.8 million Virginians, paid $5.95 million in fines and $23 million in restitution to its subscribers after an investigation showed policyholders were overcharged for services.
Gilmore said the payments are only a portion of a $600 million cash surplus Trigon accumulated, in part because of treatment discounts the health care company received but did not pass on to those it insured.
Trigon did not admit any wrongdoing, either in paying the $5 million settlement or a subsequent $950,000 settlement for misleading advertising.
``Our assessment is that Trigon anxiously wanted us to end our investigation,'' Gilmore said. ``But we continued, in part because of Trigon's refusal to admit any wrongdoing.'' Gilmore said his office investigated whether the health care provider was guilty of any criminal conduct, but found it was not.
He also said his office, along with the U.S. attorney general and the State Corporation Commission, concluded that Trigon's leadership allowed the company to show ``callous disregard for the interests of individual patients and a gross indifference to the consumers of Virginia.''
Trigon officials called Gilmore's comments misleading and erroneous. ``It is simply a rehash of what has previously been disclosed and dealt with,'' said Norwood H. Davis Jr., Trigon chairman. ``This statement by the attorney general is not constructive criticism, but is highly harmful to Trigon and its policyholders and employees.''
Gilmore said senior officials at Trigon have continued to show a lack of accountability and failed to ensure against a repeat of the deception, and said a recent $245,000 bonus paid to Davis demonstrates his point.
``Trigon made millions of dollars at the expense of patients by shifting costs to patients without their knowledge,'' Gilmore said.
``Trigon should not keep this money or any part of the $600 million surplus which can be attributed to its deceptive practices,'' he said.
Gilmore also said he has serious concerns about Trigon's plans to switch from a nonprofit mutual company owned by policyholders to a for-profit stock company. He said he hopes Trigon will address his questions ``before it is allowed to ask the public to buy its stock.''
by CNB