Navigation Links
CA Legislature's 'Reform' of Health Insurance Cancellations Resembles Insurance Industry's Own Plan; Insurers, Satisfied With Getting a Legal Edge Against Patients, Drop Opposition to the Bill
Date:6/23/2008

For a rescission to be rightful, an insurer must prove a patient

misrepresented a health fact that materially affected the insurer's

decision to grant coverage.

-- Even if a third party panel includes laypersons and legal experts, it is

not good policy to have a company -- whether for-profit or nonprofit --

with financial interest in retaining its contract with the state replace

a judge and jury.

-- The "facts" of a rescission review -- whether a patient lied

-- require an exhaustive review of the rescinded patient's actions,

unlike existing third-party medical reviews that consider the

particulars of a diagnosed medical condition and do not require an

interaction with the patient. The two situations cannot be compared.

-- The existing third-party independent medical review has come under

increased scrutiny and criticism for failing to observe the appropriate

statutory requirements when conducting reviews, and the Department has

been lax in its oversight.

-- Insurers may at any time bring pressure to bear on the regulators and

seek termination of a contract if a reviewer too often returns

unfavorable results. In fact, the IMR review process under a company

known as Maximus sides with health plans in 70% of the cases it reviews.

That's why the insurance companies have publicly supported the same

system for rescission.

-- The great majority of rescissions involve the actions of insurance

brokers who often counsel patients about how to fill out the complex

applications of the individual insurance -- recommendations that are

often colored by the insurance agent's financial incentives in

selling coverage. Who would review the agent's action in the

third-party review? Who would judge the weight of that evidence?

-
'/>"/>

SOURCE Consumer Watchdog
Copyright©2008 PR Newswire.
All rights reserved

Page: 1 2 3 4 5

Related medicine news :

1. Assembly on the Move for Rx Reform
2. Bayer Announces Availability of Reformulated Liquid Leukine(R)
3. ACP says major system reforms needed to improve the state of primary care medicine in the US
4. AARP Statement on Governors Bill for Prescription Drug Marketing Reform and Transparency
5. Presidential Candidates Health Care Plans Lack Key Reform Elements, Aspen Institute Finds
6. CEOs From Multiple Health Industries Announce Consensus Plan to Reform U.S. Health Care
7. Aspen Institute to Release Presidential Candidates Responses to Health Care Reform Questionnaire; New Zogby Poll Findings Also to be Released
8. SEIU Retaliates Against California Caregivers & Democratic Reform Movement
9. Photos: New Kind of Health Care Reform Brings Five-Star Hospitality to Hospital Care
10. Voters Believe They Hold Power in Health Care Reform Debate
11. Kidney Care Community Applauds National Taxpayers Unions Endorsement of Medicare Reforms to Extend Patient Private Health Insurance Coverage; Calls Proposal Common Sense Coverage Reform
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/31/2014)... HealthDay Reporter THURSDAY, Oct. 30, ... additional $100 million in the fight against the Ebola outbreak ... the World Bank,s total pledge to more than $500 million, ... to the three hardest-hit countries -- Guinea, Liberia and Sierra ... has increased significantly in recent weeks, but we still have ...
(Date:10/31/2014)... Oct. 30, 2014 (HealthDay News) -- Wearing masks made ... festivities that could be risky for children with asthma, ... association advises parents to be proactive about managing their ... enjoyable. Some of the steps they recommend parents ... and haunted houses are exciting adventures that can lead ...
(Date:10/31/2014)... Steven Reinberg HealthDay ... Leprosy, although quite rare, continues to appear in the United ... new cases are reported in the United States each year, ... said. That compares to about 250,000 cases that occurred worldwide ... times, leprosy is an infectious disease that causes skin sores, ...
(Date:10/31/2014)... — A new report by Milken Institute School ... George Washington University examines the challenge of maintaining ... enrolled in Covered California and who are also ... Services Program (CPSP). The CPSP, whose roots are ... ever developed for low-income pregnant women, makes enriched ...
(Date:10/30/2014)... an institutional patient registry on stereotactic body radiotherapy ... of tumors, for medically inoperable, early stage lung ... 2012, according to research presented today at the ... Symposium is sponsored by the American Society of ... Oncology (ASTRO), the International Association for the Study ...
Breaking Medicine News(10 mins):Health News:World Bank Pledges $100M More to Fight West Africa's Ebola Outbreak 2Health News: Halloween Safety Tips for Kids With Asthma 2Health News:Leprosy Still Occurs in U.S., CDC Reports 2Health News:Leprosy Still Occurs in U.S., CDC Reports 3Health News:Report examines health care challenges for pregnant women enrolled in covered California 2Health News:Sustained local control for medically inoperable, early stage lung cancer patients 2Health News:Sustained local control for medically inoperable, early stage lung cancer patients 3
... Health has awarded $10.24 million to Fred Hutchinson Cancer ... to understand and prevent breast cancer disparities in Hispanic ... nationwide to receive funding as part of the NIH ... is launching a major new effort to understand and ...
... a specific type of dopamine receptor gene respond ... without the genotype, according to new research from ... come from the first-ever placebo-controlled pharmacogenetic drug trial ... to evaluate variants of the DRD4 dopamine receptor ...
... According ... the ages of 25 and 34 report being taught to practice defensive medicine. , ... Atlanta, GA (PRWEB) May 3, 2010 -- According to ... of physicians between the ages of 25 and 34 report being taught to practice defensive medicine., ...
... ... National Lupus Awareness Month 2010 with a 115-sq-ft display window at 10 Rockefeller Plaza to ... in the heart of New York City, was generously donated by EHE International for the ... (PRWEB) ...
... Mass. -- Our DNA is under constant siege from a ... of cells to repair that damage has broad health implications, ... used to study DNA damage are quite limited, but MIT ... analysis that promises to make an impact on human health. ...
... 3, 2010) The results of new research results ... of the American College of Surgeons show that ... a hospital surgical ward. Postoperative pneumonia is ... third most common infectious complication after urinary tract and ...
Cached Medicine News:Health News:Hutchinson Center receives $10.24 million from NIH for Latina breast cancer research 2Health News:Hutchinson Center receives $10.24 million from NIH for Latina breast cancer research 3Health News:Hutchinson Center receives $10.24 million from NIH for Latina breast cancer research 4Health News:Hutchinson Center receives $10.24 million from NIH for Latina breast cancer research 5Health News:Research helps end guesswork in prescribing ADHD drug 2Health News:Young Physicians Taught to Practice Defensive Medicine, Survey Finds 2Health News:Young Physicians Taught to Practice Defensive Medicine, Survey Finds 3Health News:Lupus Awareness Month Kicks Off at Rockefeller Center: EHE International Donates Display Window to S.L.E. Lupus Foundation for May 2Health News:Lupus Awareness Month Kicks Off at Rockefeller Center: EHE International Donates Display Window to S.L.E. Lupus Foundation for May 3Health News:Rapid analysis of DNA damage now possible 2Health News:Surgeons' pilot prevention program reduces incidence of postoperative pneumonia 2
(Date:10/31/2014)... Oct. 31, 2014  Zacks.com announces the list of stocks featured ... discuss the latest news and events impacting stocks and the financial ... AMGN - Free Report ), Celgene (Nasdaq: ... BIIB - Free Report ), Market Vectors Biotech ETF (AMEX: ... Biotech ETF (AMEX: XBI - Free Report ). ...
(Date:10/31/2014)... BARCELONA , October 31, 2014 ... infringe two Australian patents of B. Braun Melsungen AG (B. ... Australia safety IV catheters manufactured by Poly Medicure ... Australia proceeding number VID 463 of ... In the detailed judgment, Multigate was found to have ...
(Date:10/31/2014)... 2014 Electronic prescribing or E-Prescribing ... prescription related information between prescriber, dispenser and ... physician and nurse practitioner to transmit a ... occurs during pharmacy operations. E-Prescribing system has ... complete medical lists, conducts all security checks ...
Breaking Medicine Technology:The Zacks Analyst Blog Highlights: Amgen, Celgene, Biogen Idec, Market Vectors Biotech ETF and SPDR S&P Biotech ETF 2The Zacks Analyst Blog Highlights: Amgen, Celgene, Biogen Idec, Market Vectors Biotech ETF and SPDR S&P Biotech ETF 3The Zacks Analyst Blog Highlights: Amgen, Celgene, Biogen Idec, Market Vectors Biotech ETF and SPDR S&P Biotech ETF 4The Zacks Analyst Blog Highlights: Amgen, Celgene, Biogen Idec, Market Vectors Biotech ETF and SPDR S&P Biotech ETF 5The Zacks Analyst Blog Highlights: Amgen, Celgene, Biogen Idec, Market Vectors Biotech ETF and SPDR S&P Biotech ETF 6The Zacks Analyst Blog Highlights: Amgen, Celgene, Biogen Idec, Market Vectors Biotech ETF and SPDR S&P Biotech ETF 7B. Braun Wins Patent Disputes Against Poly Medicure Ltd's Australian Distributor Multigate Medical Devices Pty. Ltd. and Spanish Distributor Dextromédica S. L. 2E-Prescribing Market - Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2013 - 2019 2
... Feb. 14, 2012 The Alliance for Safe Biologic ... Thursday, February 16th at 3:30 p.m. EST, focusing on biologic medicines ... of the Alliance, will also discuss the newly released ... Webinar III: Pharmacovigilance: What is it and why ...
... Feb. 14, 2012 The Center for Regulatory ... slash reimbursement to state Medicaid programs for beneficiaries ... Equipment.  The proposed budget would cripple the ability ... Instead of protecting the viability of home medical ...
Cached Medicine Technology:Alliance for Safe Biologic Medicines Announces New Webinar on February 16 2President's Budget Declares War on Medicaid Recipients 2
Microwell IRMA for the detection of Intact PTH...
Mircrowell EIA for detection of Intact PTH...
... Loading Units with Stainless Steel Staples for ... ,Utilizing a disposable loading unit, the LDS-2™ ... ligate the tissue within the cartridge jaw ... between the two closed clips. The instrument ...
... The Auto Suture™ Powered LDS™ single ... ligate tissue within the cartridge jaw and ... the two closed staples. , ,The ... with titanium staples have application in abdominal, ...
Medicine Products: