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

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-- require an exhaustive review of the rescinded patient's actions,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:
(Date:12/21/2014)... Hills, Ca (PRWEB) December 21, 2014 ... Khanna was a guest at the Aspen Helicopters holiday ... kids and a Santa with sleigh, flown by an ... helicopter appeared invisible; only Santa with sleigh was visible.(please ... during day and night. Dr.Khanna has helped many pilots ...
(Date:12/21/2014)... Recently, one of the best prom dresses online shops ... introduced its new collection of 2015 prom dresses, and ... its prom dresses & other fashionable designs, up to ... quality dress products and great customer services to its ... the best prom dresses online shops around the world ...
(Date:12/21/2014)... (PRWEB) December 21, 2014 Over the ... performance issues in hundreds of emergency departments across the ... Its findings have been translated into an innovative suite ... to correct deficiencies and enhance the patient experience. ... emergency physician staffing and management services for hospitals, announced ...
(Date:12/21/2014)... The Oncology Institute of Hope and Innovation hosted ... Whittier offices. The Hope for the Holidays Toy Drive is ... their families during the holiday season. This year, the toy ... between both offices. This event continues to be successful year ... team, store managers and assistant managers came out and not ...
(Date:12/20/2014)... has recently announced its new collection of sweet 16 ... dresses for the coming new year. , ... global women. Now, all the models on its website ... Among the new items, the model of 10986064 (Fresh ... popular. What’s more, also provides a fast and ...
Breaking Medicine News(10 mins):Health News:New Prom Dresses From One Of The Best Prom Dresses Online Shops, LunaDress Prom Shop 2Health News:NES Health Launches Stipend Program for Emergency Physicians in Training to Financially Assist Emergency Department Doctors While They Learn 2Health News:Tons of New-in Winter Sweet 16 Dresses from Weddingshe Online Now 2
... survey conducted by Synovate India and sponsored by Colgate-Palmolive (India) ... and the latest toothpaste available in the market, //the level ... of those surveyed admitted that they have never been to ... that poor oral hygiene practices are resulting in a myriad ...
... more than 5.13 million patients are suffering from AIDS ... being reported each year. Anti-retroviral treatments //have already been ... ,The priority of the Indian Government is to save ... Inorder to increase awareness and promote community participation, of ...
... his research team from Kyoto University have found that daily ... The results of the study have been published in the ... conducted in 387 healthy volunteers between the age group of ... into three groups, the first group gargled water with povidone-iodine, ...
... growing number of animal and human studies show that ... pain sensitivity, resulting in hyperalgesia (abnormally intense pain in ... in response to non-painful stimulation). , ... previous studies have found evidence for hyperalgesia only subsequent ...
... findings released by University of Florida doctors claim that some ... radiation therapy if they undergo a CT scan.// This scan ... the researchers claim. ,These findings were presented at ... and Oncology. Stanley L. Liauw, M.D., a resident in radiation ...
... was first initiated in India to help overcome Vitamin ... in India, it now lags behind African and neighbouring ... report.,The report entitled "Controlling Vitamin and Mineral Deficiencies in ... the largest percentage as well as the largest absolute ...
Cached Medicine News:Health News:Condom Vending Machines To Be Installed Across Indian States 2Health News:Daily Gargling May Prevent Common Colds 2Health News:Opioids And Abnormal Pain Perception 2Health News:Vitamin A supplementation inadequate in India: Need for effective strategies 2
(Date:12/19/2014)...  Monarch America Inc. (OTCQB: CANK) ("Monarch America" or ... provide this review of the Company,s recent achievements and ... "Over this past year, we achieved many of our ... to say that Monarch America is in a stronger ... been," stated Eric Hagen , CEO of Monarch ...
(Date:12/19/2014)... Research and Markets ( ... "Micro Market Monitor: North American Dermatology Diagnostic Devices ... Cosmetic ... has resulted in fueling the overall demand of ... of these dermatology devices is to assist in ...
(Date:12/19/2014)... DIEGO , Dec. 18, 2014  RESMED INC. (NYSE: ... its second quarter of fiscal year 2015 results on Thursday, ... close. A press release with ResMed,s results will be issued ... host a webcast to discuss operating results and future outlook. ... 1:30 p.m. US Pacific Time and the live webcast of ...
Breaking Medicine Technology:Monarch America Inc. CEO Reviews Recent Achievements and Provides Outlook for 2015 2Monarch America Inc. CEO Reviews Recent Achievements and Provides Outlook for 2015 3Micro Market Monitor: North American Dermatology Diagnostic Devices Market 2Micro Market Monitor: North American Dermatology Diagnostic Devices Market 3ResMed To Announce Second Quarter 2015 Results 2
... Inc. (Nasdaq: IDIX ), a biopharmaceutical company engaged ... of human viral diseases, today announced that two abstracts have ... the European Association for the Study of the Liver (EASL, ... can now be viewed at the EASL website at ...
... (Nasdaq: IDIX ) announced today that management will ... Stock Conference on Monday, March 14, 2011 at 12:00 p.m. ... California and at the Barclays Capital 2011 Global Healthcare Conference ... the Loews Miami Hotel, Florida. The live and ...
Cached Medicine Technology:Idenix Announces Data Presentations at the 46th Annual Meeting of the European Association for the Study of the Liver (EASL) 2Idenix Announces Data Presentations at the 46th Annual Meeting of the European Association for the Study of the Liver (EASL) 3
Modular Specimen Filing System has five cells that can hold either slides or tissue cassettes....
... an expanded database containing over 330 ... cards, VITEK 2 Compact offers enhanced ... of time (2 to 14 hours), ... microorganisms that contaminate production areas and ...
... is a comprehensive hemodynamic monitoring and ... lab. Patient demographics, clinical hemodynamic ... procedural information all flow seamlessly into ... repetitive data entry. Both ...
... generation product is a patient monitoring system ... parameters, sensed at the tissue level, reflecting ... tissue by low power light and detects ... tissue. The light is guided to the ...
Medicine Products: