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-- require an exhaustive review of the rescinded patient's actions,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:7/30/2014)... CT (PRWEB) July 30, 2014 It is ... Affair proved this to be true as a product ... Conference in Las Vegas this past June. , Lash ... artists and overall success of the eyelash industry through collaboration ... very proud to have supported NEESA ’s event. Lash ...
(Date:7/30/2014)... Recently, Agebc.com, one of the most ... its new line of affordable flower girl dresses ... in several popular styles: sequined ball-gown, scoop neckline, fully ... company’s fresh assortment are: short chiffon dresses with delicate ... of course the classic beautiful colored tulle flower girl ...
(Date:7/30/2014)... University of Adelaide psychology researchers has shed new light ... teens. , School of Psychology PhD student ... students aged 12-18 to better understand their sleep habits, ... were most active (known as their "chronotype"). , The ... Medicine , may have implications for the clinical ...
(Date:7/30/2014)... More accurate tests could be created to diagnose diseases ... injuries, leading to earlier intervention, according to new findings ... involved investigating the components of memory using a combination ... be used to create a diagnostic tool for distinguishing ... or forms of amnesia caused by head trauma. ...
(Date:7/30/2014)... 4DSP’s new CES720 (Compact Embedded System) is ... provide a complete and generic processing platform for data ... in an enclosure measuring five inches per side and ... x86 CPU tightly coupled to a high-performance Xilinx ... VITA 57.1). The Kintex-7 410T FPGA provides a ...
Breaking Medicine News(10 mins):Health News:Lash Affair Launches a New Product as Sponsor of the First U.S. Lash Extension Competition 2Health News:Affordable Flower Girl Dresses Recently Unveiled at Agebc.com 2Health News:Teen insomnia is linked with depression and anxiety 2Health News:Hope for more accurate diagnosis of memory problems 2Health News:4DSP Introduces a Compact Platform for UAVs with Embedded Processing and Flexible IO 2Health News:4DSP Introduces a Compact Platform for UAVs with Embedded Processing and Flexible IO 3Health News:4DSP Introduces a Compact Platform for UAVs with Embedded Processing and Flexible IO 4
... ET , , Covers Europe, Middle East and ... , , Includes Licensing Option and Development Funding for ... England, June 22 NeurogesX, Inc. (Nasdaq: NGSX ) and ... Pharma Inc. announced today that the companies have entered into an exclusive ...
... ... services company , ... Westminster, Colo. (PRWEB) June 22, 2009 -- Silver Creek Systems®, the pioneer ... today that their DataLens™ System was selected by McKesson Medical-Surgical to automate the processes ...
... , Web Site Features "Anesthesia & Me"(C) Checklist ... Preparation for Surgery , , LifelinetoModernMedicine.com Provides ... , CHICAGO, June 22 Every year, ... of inpatient surgery. To help educate and inform ...
... guided imagery has been steadily gaining in popularity and ... new research demonstrates its efficacy for producing heightened immune ... A new self-help audio recording designed to strengthen natural ... and bacterial illnesses was released this week by Health ...
... Taiwan, June 22 /PRNewswire-Asia/ -- The Healthcare & ... of a Memorandum of,Understanding (MOU) with the Science ... non-profit organization under the National,Applied Research Laboratories in ... for Taiwan,s Science & Technology (S&T) development. , ...
... ... by Esco. The videos can be viewed at: http://us.escoglobal.com/resources/hospital-pharmacy-products/videos.php . , ... Hatboro, PA (PRWEB) June 22, ... education videos for the compounding pharmacy industry. Titled "Pharmacy Isolator Safe Use ...
Cached Medicine News:Health News:NeurogesX and Astellas Enter Commercialization Agreement for Qutenza(TM) 2Health News:NeurogesX and Astellas Enter Commercialization Agreement for Qutenza(TM) 3Health News:NeurogesX and Astellas Enter Commercialization Agreement for Qutenza(TM) 4Health News:NeurogesX and Astellas Enter Commercialization Agreement for Qutenza(TM) 5Health News:NeurogesX and Astellas Enter Commercialization Agreement for Qutenza(TM) 6Health News:McKesson Medical-Surgical Selects DataLens System to Automate Product Data Mastering 2Health News:American Society of Anesthesiologists Launches Web Site Focused on Educating and Empowering the Public about Anesthesiology 2Health News:American Society of Anesthesiologists Launches Web Site Focused on Educating and Empowering the Public about Anesthesiology 3Health News:Cancer Patients Use New Guided Imagery CD to Help Boost Healthy Immune Functioning 2Health News:Cancer Patients Use New Guided Imagery CD to Help Boost Healthy Immune Functioning 3Health News:Taiwan's Science & Technology Policy Research and Information Center (STPI) and Thomson Reuters Sign MOU of Collaboration to Support Science & Technology Development 2Health News:Taiwan's Science & Technology Policy Research and Information Center (STPI) and Thomson Reuters Sign MOU of Collaboration to Support Science & Technology Development 3Health News:New Compounding Pharmacy Videos Provide Product Information, Teach Safety 2Health News:New Compounding Pharmacy Videos Provide Product Information, Teach Safety 3
(Date:7/30/2014)... Research and Markets has announced the addition ... Report 2014" report to their offering. ... and Chinese Aseptic Packaging Industry Report is a professional ... global Aseptic Packaging industry with a focus on the ... of the industry including definitions, classifications, applications and industry ...
(Date:7/30/2014)... NEW YORK , July 30, 2014 /PRNewswire/ ... report is available in its catalogue: ... http://www.reportlinker.com/p0356852/mHealth-and-Home-Monitoring-–-6th-Edition.html Executive ... services are delivered, leading to better outcomes, decreased ... The market for mHealth solutions is still in ...
(Date:7/30/2014)...  Decision Resources Group finds that ... imaging system market will be significantly driven by ... computed tomography and magnetic resonance imaging with nuclear ... the need for higher-quality imaging to satisfy more ... spur preclinical imaging system sales. Other ...
Breaking Medicine Technology:Global and Chinese Aseptic Packaging Industry Report 2014 2mHealth and Home Monitoring - 6th Edition 2mHealth and Home Monitoring - 6th Edition 3mHealth and Home Monitoring - 6th Edition 4mHealth and Home Monitoring - 6th Edition 5mHealth and Home Monitoring - 6th Edition 6mHealth and Home Monitoring - 6th Edition 7mHealth and Home Monitoring - 6th Edition 8mHealth and Home Monitoring - 6th Edition 9mHealth and Home Monitoring - 6th Edition 10mHealth and Home Monitoring - 6th Edition 11Growing Popularity of Multimodality Imaging Will Drive the Preclinical Animal Research Imaging System Market 2
69" 5 shelves electric rotating display with gunmetal grey frame. Lead time 6-8 weeks....
... impact for the marketing of optical frames ... frames allows your retail area to maximize ... eye-catching displays. The products are shown at ... Removable holders. Variable number of frames displayed ...
A quarter-vision dispensing case or table with a 6" high glass display area and halogen lights. Based on size of case, enjoy either 4, 5.5, 7 or 8 square feet respectively of elegant shelf space for ...
Eye-Kraft is an independent, full-service ophthalmic laboratory. It offers first-quality products, same-day service and overnight delivery with ongoing research and development....
Medicine Products: