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Pennsylvania HMO fined for pricing violations.(Legal Pulse)(Health maintenance organizations)(Brief Article)
Pennsylvania regulators recently imposed a $1.6 million fine against HealthGuard of Lancaster, Inc. for undercharging and overcharging for group health care policies.
HealthGuard, a subsidiary of Highmark, Inc., offers managed care health plans in central Pennsylvania and the Lehigh Valley. The fine, which was part of a November 3 consent order, is the largest penalty the Pennsylvania Insurance Department has ever imposed on a health insurer.
Under a Pennsylvania law known as Act 159, insurers must file for special approval of any rates that deviate, either up of down, from approved rates by more than 15%. HealthGuard failed to do that and …
