Washington Insurance Commissioner Mike Kreidler has announced LifeWise Health Plan of Washington and Evolent Health LLC will pay $225,000 in fines for gender discrimination in approving health insurance claims.
Kreidler fined LifeWise $150,000 and Evolent (LifeWise’s health care benefit manager) $75,000 in orders filed on Sep. 12 after a patient filed a claim for reproductive care with LifeWise in 2022 and was denied a week later.
The patient was told the requested procedure was atypical for their gender and that they would need to produce additoinal medical records to reprocess the claim, the Office of the Insurance Commissioner reports.
The provider’s office, according to the OIC, contacted LifeWise about the claim and got the same response, and the patient contacted LifeWise twice more to no avail before giong to Kreidler’s office.
Four days after the patient filed a complaint with the OIC, the patient was told by LifeWise their claim would be reprocessed and paid, Kreidler’s office reports.