Payor Updates
In November 2025, Regence BlueShield was fined by Washington’s insurance commissioner for violating the Mental Health Parity and Addiction Equity Act (MHPAEA). This law requires behavioral healthcare to be covered no more restrictively than general medical care. The insurance commissioner, Patty Kuderer, stated that Regence violated MHPAEA by reporting insufficient data to show compliance with the law.
Regence was found to have disparities between behavioral health benefits and medical and surgical benefits, but when asked, they failed to provide an explanation that justified these differences. The health insurer also could not identify why there were large differences in its in-network reimbursement rates and service provider negotiation rates and its provider participation rates.
Kuderer stated that “Regence’s staff appeared to willfully misinterpret our questions, dismiss our concerns, and generally disregard their own responsibilities to their members’ well-being.”
In addition to differences in behavioral health rates and medical health rates, the insurer withheld the criteria it used to set provider rates and treatment limitations. The Insurance Commissioner found Regence to violate MHPAEA across 2019 and 2023.
As a result, Regence was fined $550,000 for applying benefit determinations more stringently on behavioral healthcare compared to general medical healthcare. Regence responded to the fine, claiming that state and federal requirements were implemented in good faith.
State involvement in disciplining payors like Anthem BlueShield shows the benefit of keeping our regulatory bodies up to date with bad actions from insurers. Interface works hard to ensure that, where needed, our providers have the tools to get help from the authorities in securing fair treatment. We also encourage all providers to make use of the Department of Managed Healthcare’s provider grievance tool, which can be accessed at: https://www.dmhc.ca.gov/FileaComplaint/ProviderComplaintAgainstaPlan.aspx