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Consumer Affairs Official Defends State's Right To Review Rates

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An appeals board has rejected a move by the Patrick administration to curb health care premiums for Harvard Pilgrim Health Care subscribers, but the state says it will continue to review — and sometimes reject — insurers' rate changes.

The ruling by an appeals board at the Massachusetts Division of Insurance reversed a decision — made by Insurance Commissioner Joseph Murphy last April — to reject Harvard Pilgrim’s proposed rate hikes, saying they were excessive.

The appeals board said the proposed increases were reasonable because of what insurance companies have to pay to health care providers.

In a conversation with WBUR's Bob Oakes, Undersecretary for Consumer Affairs Barbara Anthony said the Division of Insurance still has the legal right to review the rest of the insurance rates that come up for approval throughout the year.

"We're not backing off," Anthony said. "We are going forward. We have the legal authority to review the rates. We're going to continue to do that. "

Anthony explained that only 25 of more than 200 providers' rates were affected by the appeals board's decision, adding that providers must file their rates for review multiple times a year.

"This is one set of rates for one set of contract renewals," Anthony said. "We are going to continue to use the authority that the commissioner has to disapprove unreasonable or excessive rates."

Anthony explained that the insurance division wants to find a way to work directly with insurance companies and health care providers to bring rates down, avoiding future legal clashes.

"What we want is to come together to come up with common solutions to drive down double-digit rate increases that families and small businesses have been enduring here in the state," she said.

A spokesman for Harvard Pilgrim has not returned calls for comment.

This program aired on June 25, 2010.

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