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-- require an exhaustive review of the rescinded patient's actions,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:8/22/2014)... 2014 (HealthDay News) -- An intensive effort to sterilize feral ... shelter in Florida and euthanized, a new study reveals. ... slow their intake into animal control," Dr. Julie Levy, a ... of Veterinary Medicine, said in a university news release. ... a big impact," she explained, "so we wanted to pick ...
(Date:8/22/2014)... Dayton Children's Hospital broke ground on a historic new, eight-story, ... campus renewal. Renderings of the exterior of ... , The new patient tower is part of a ... meets the needs of patients, families and care providers well ... Children’s unique patient care mission and offer places that facilitate ...
(Date:8/22/2014)... has again attained the distinguished Magnet hospital designation ... Recognition Program. Considered the gold standard for nursing ... excellence and professionalism. It is the top international ... to redesignate Newport Hospital was based on the ... nursing practice. , "It is a privilege for ...
(Date:8/22/2014)... FRIDAY, Aug. 22, 2014 (HealthDay News) -- People who ... for the lower levels of nicotine, according to a ... toxic chemicals than other smokers, the researchers say. ... to 65, who smoked regular cigarettes with nicotine emission ... The participants then switched to reduced-nicotine cigarettes for the ...
(Date:8/22/2014)... 2014 (HealthDay News) -- Inner city children have a higher-than-normal ... Researchers followed 516 inner city children in four U.S. cities ... birth until age 5 and found that at least 10 ... peanuts. Because only the three most common types of ... of inner city youngsters with food allergies may be even ...
Breaking Medicine News(10 mins):Health News:Neutering Project Curbed Feral Cat Population 2Health News:Dayton Children's Hospital Breaks Ground on New, Eight-story Patient Care Tower 2Health News:Dayton Children's Hospital Breaks Ground on New, Eight-story Patient Care Tower 3Health News:Dayton Children's Hospital Breaks Ground on New, Eight-story Patient Care Tower 4Health News:Dayton Children's Hospital Breaks Ground on New, Eight-story Patient Care Tower 5Health News:Newport Hospital receives nursing's highest credential for third time with Magnet recognition 2Health News:Low-Nicotine Cigarettes May Not Lead to More Smoking 2Health News:Food Allergies More Common Among Inner City Kids, Study Finds 2
... , , KNOXVILLE, Tenn. , Jan. ... offers free healthcare services in underdeveloped countries and in the U.S., ... to assist in the Haiti earthquake relief efforts at ... the Haitian border. Founder Stan Brock and RAM volunteers ...
... Humanitarian Group,s Response Targets Vulnerable Women and Children , ... Saturday that pregnant women, breastfeeding mothers and young children are at ... the Haitian capital of Port-au-Prince and left nearly three ... pregnant women among the affected population in urgent need of safe ...
... strongest during female ovulation, study finds , MONDAY, ... attract a man,s attention shouldn,t wear perfume, new research ... Miller and Jon K. Maner found that male testosterone ... particularly during ovulation, which is when women are most ...
... dire and must be monitored, study says , MONDAY, Jan. ... just have a minor head bump, but a brain injury ... Canadian researchers warn. , Parents often believe that concussion ... said lead researcher Dr. Carol DeMatteo, an associate clinical professor ...
... ... Internal Medicine and Occupational Health. , ... Berkeley Heights, N.J. (Vocus) January 18, 2010 -- Renée Schreiber Chervenak, ... , , , ,Dr. Chervenak earned her B.A. summa cum laude at Boston University ...
... ... Orthopedic Devices is Enabled , ... (PRWEB) January 18, 2010 -- Oxford Performance Materials (OPM) ... nail for long-bone fractures called the Quantum Composite Nailing System™. N.M.B.,s Quantum Composite ...
Cached Medicine News:Health News:Remote Area Medical Travels to Haiti to Assist in Earthquake Relief Efforts 2Health News:Remote Area Medical Travels to Haiti to Assist in Earthquake Relief Efforts 3Health News:CARE: Tens of Thousands of Pregnant Women at Risk in Haiti 2Health News:CARE: Tens of Thousands of Pregnant Women at Risk in Haiti 3Health News:Parents Not Taking Concussions Seriously Enough 2Health News:Parents Not Taking Concussions Seriously Enough 3Health News:Summit Medical Group Welcomes Rene Schreiber Chervenak, M.D. 2Health News:Innovative Orthopedic Nailing System Receives CE Mark using Oxford Performance Material's OXPEKK BioFlex™ 2
(Date:8/21/2014)...  Aptuit LLC announces that Aptuit SSCI, located ... has enhanced its capabilities in the areas of ... molecules, including biologic drugs, metabolites, and polymers, through ... spectrometer. In making the announcement, Dr. ... expanded large molecule capability enhances our early development ...
(Date:8/21/2014)... The spinal column is one of the most ... to and from the brain through the column control many ... or ailment here can be life altering, and leave the ... over their body. Though back injury and disease can have ... more options available to make things better than ever before. ...
(Date:8/21/2014)... , Aug. 21, 2014 /PRNewswire-iReach/ -- Inc. ... Inc. for the third straight year, No. 349 ... an exclusive ranking of the nation,s fastest-growing private ... at the most important segment of the economy—America,s ... Dell, Domino,s Pizza, LinkedIn, Zillow, and many other ...
Breaking Medicine Technology:Aptuit SSCI Adds Ultra High Resolution Q-TOF Mass Spectrometer for Large & Small Molecule Analyses 2Don't Live in Pain: Four Life Improving Benefits of Back Surgery 2Carolina's HME Named for Third Straight Year to Inc. Magazine's List of America's Fastest-Growing Private Companies--the Inc. 5000 2Carolina's HME Named for Third Straight Year to Inc. Magazine's List of America's Fastest-Growing Private Companies--the Inc. 5000 3
... Show Improved Symptomatic Status, Cardiac Function and ... Failure in both Functional and Degenerative MR ... show percutaneous mitral repair using the MitraClip(R) ... either functional mitral regurgitation (FMR) or degenerative ...
... and BARCELONA, Spain, May 20 Boston Scientific Corporation ... an analysis of economic and quality of life outcomes, ... The results found that percutaneous coronary intervention (PCI) ... consistently associated with fewer patient hospital days during the ...
Cached Medicine Technology:MitraClip(R) Therapy Data Demonstrate Clinical Benefit in High-Risk Patients With Mitral Regurgitation 2MitraClip(R) Therapy Data Demonstrate Clinical Benefit in High-Risk Patients With Mitral Regurgitation 3MitraClip(R) Therapy Data Demonstrate Clinical Benefit in High-Risk Patients With Mitral Regurgitation 4SYNTAX Analysis Finds Treatment With TAXUS(R) Express2(R) Stent System More Cost Effective Than Bypass Surgery in Patients With Complex Coronary Artery Disease 2SYNTAX Analysis Finds Treatment With TAXUS(R) Express2(R) Stent System More Cost Effective Than Bypass Surgery in Patients With Complex Coronary Artery Disease 3SYNTAX Analysis Finds Treatment With TAXUS(R) Express2(R) Stent System More Cost Effective Than Bypass Surgery in Patients With Complex Coronary Artery Disease 4SYNTAX Analysis Finds Treatment With TAXUS(R) Express2(R) Stent System More Cost Effective Than Bypass Surgery in Patients With Complex Coronary Artery Disease 5
The Auto Suture DFS stapler is a disposable fascia stapler. The stapler places one staple each time the instrument handles are activated. The staples first penetrate the fascia and are then formed, t...
... PROXIMATE RH skin stapler is a full-feature ... assembly., ,PROXIMATE RH has improved visibility ... with a ratchet mechanism for easier staple ... sterile, single patient use instrument designed to ...
... Reloadable Linear Staplers deliver two staggered rows of ... They may be reloaded up to three times ... fire heavy wire staples for thick tissue. The ... interchangeable., ,Benefits include: , Parallel jaw closure ...
... Use Loading Units for use ... Use Reloadable Staplers with Titanium ... TA™ Reloadable staplers has application ... thoracic surgical procedures for resection ...
Medicine Products: